41 research outputs found
THE EFFECT OF DIGITALIS ON THE NORMAL ELECTROCARDIOGRAM
With the advent of newer leads to the electrocardiogram it has become necessary to repeat the observations that have been made in the past on the cardiographic changes following digitalis administration in healthy subjects. The main object of this work has been to determine the lead or leads most susceptible to the effects of digitalis as well as the design of the deformity produced in the tracing. The need for the investigation has arisen from the common practice of giving digitalis to a patient considered to have heart disease before the electrocardiogram is recorded as part of a special examination. Confusion in diagnosis is specially likely if chest pain is included among the symptoms-a circumstance that allots more than ordinary importance to changes in the electrocardiogram. Methods. The dosage of digitalis leaf was that customarily used in the continuous treatment of a patient needing it. It was, therefore, given in the first place as 2 grains (0-13 g.) daily and later increased to 3 grains (0-2 g.) daily. Rapid digitalization was not followed. Thirteen healthy medical students volunteered to take digitalis during a period of six to eight weeks when the total dosage was from 104 to 135 grains (6 9-9 g.). Digitalis was dispensed to each student when he attended the Cardiac Department to ensure accuracy in regard to the amount taken. A preliminary electrocardiogram was taken before th
Systemic chemotherapy in inoperable or metastatic bladder cancer
Urothelial cancer is a common malignancy. The management of patients
with recurrent disease after cystectomy or initially metastatic or
unresectable disease represents a therapeutic challenge. Systemic
chemotherapy prolongs survival but long-term survival remains
infrequent. During recent years there has been improvement due to the
use of novel chemotherapeutic agents, mainly gemcitabine and the
taxanes. The long-considered-standard MVAC has been challenged by
combinations showing more favourable toxicity profiles and equal
(gemcitabine-cisplatin) or even improved (dose-dense, G-CSF-supported
MVAC) efficacy. Specific interest has also been generated in specific
groups of patients (elderly patients, patients with renal function
impairment or comorbidities), who are not fit for the standard
cisplatin-based chemotherapy but can derive significant benefit from
carboplatin- or taxane-based treatment. Retrospective analyses have
enabled the identification of groups of patients with different
prognoses, who possibly require different therapeutic approaches. Modern
chemotherapy offers a chance of long-term survival in patients without
visceral metastases, possibly in combination with definitive local
treatment. Finally, the progress of targeted therapies in other
neoplasms seems to be reflected in advanced bladder cancer by recent
studies indicating that biological agents can be combined with modern
chemotherapy. The true role of such therapies is currently being
evaluated
Systemic chemotherapy in inoperable or metastatic bladder cancer
Urothelial cancer is a common malignancy. The management of patients
with recurrent disease after cystectomy or initially metastatic or
unresectable disease represents a therapeutic challenge. Systemic
chemotherapy prolongs survival but long-term survival remains
infrequent. During recent years there has been improvement due to the
use of novel chemotherapeutic agents, mainly gemcitabine and the
taxanes. The long-considered-standard MVAC has been challenged by
combinations showing more favourable toxicity profiles and equal
(gemcitabine-cisplatin) or even improved (dose-dense, G-CSF-supported
MVAC) efficacy. Specific interest has also been generated in specific
groups of patients (elderly patients, patients with renal function
impairment or comorbidities), who are not fit for the standard
cisplatin-based chemotherapy but can derive significant benefit from
carboplatin- or taxane-based treatment. Retrospective analyses have
enabled the identification of groups of patients with different
prognoses, who possibly require different therapeutic approaches. Modern
chemotherapy offers a chance of long-term survival in patients without
visceral metastases, possibly in combination with definitive local
treatment. Finally, the progress of targeted therapies in other
neoplasms seems to be reflected in advanced bladder cancer by recent
studies indicating that biological agents can be combined with modern
chemotherapy. The true role of such therapies is currently being
evaluated
Bone marrow angiogenesis and progression in multiple myeloma: clinical significance and therapeutic approach
It is now well established that solid tumors depend on angiogenesis.
Promoters and inhibitors of angiogenesis are in balance and
antiangiogenic strategies aim at repressing the angiogenic process, thus
retarding solid tumor progression. Recent data suggest the importance of
angiogenesis in hematologic malignancies and several studies reveal an
increased angiogenesis in active multiple myeloma. Angiogenesis seems to
be a prominent feature of MM progression, and seems to be correlated
with the prognosis and the resistance of MM to chemotherapy. Numerous
cell populations and cytokines are involved in angiogenesis in multiple
myeloma and antiangiogenic therapy with thalidomide is effective in
patients with refractory or relapsed disease. The combination of
thalidomide and of other immunomodulatory agents with other therapeutic
regimens could lead to more effective management of patients with
multiple myeloma
Bone marrow angiogenesis and progression in multiple myeloma: Clinical significance and therapeutic approach
It is now well established that solid tumors depend on angiogenesis.
Promoters and inhibitors of angiogenesis are in balance and
antiangiogenic strategies aim at repressing the angiogenic process, thus
retarding solid tumor progression. Recent data suggest the importance of
angiogenesis in hematologic malignancies and several studies reveal an
increased angiogenesis in active multiple myeloma. Angiogenesis seems to
be a prominent feature of MM progression, and seems to be correlated
with the prognosis and the resistance of MM to chemotherapy. Numerous
cell populations and cytokines are involved in angiogenesis in multiple
myeloma and antiangiogenic therapy with thalidomide is effective in
patients with refractory or relapsed disease. The combination of
thalidomide and of other immunomodulatory agents with other therapeutic
regimens could lead to more effective management of patients with
multiple myeloma