Treatment of advanced pancreatic cancer with the long-acting somatostatin analogue lanreotide: in vitro and in vivo results

Fourteen patients with metastatic pancreatic adenocarcinoma were treated with the long-acting somatostatin (SST) analogue lanreotide. No objective response was obtained, and the median survival was 4 months (range 1.8–7 months). Pancreatic cancer could not be visualized by means of SST-receptor (R) scintigraphy in our patients. In vitro data also demonstrated absence of SSTR2 expression, suggesting pancreatic cancer not to be a potential target for treatment with SST analogues. © 1999 Cancer Research Campaig

Richter's transformation; the cause of fever of unknown origin in a case with chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL) is the most common leukemia in many countries. Infections are the most common causes of morbidity and mortality; lymphoid cell dysfunction and neutropenia associated with chemotherapy are main predisposing conditions for infection. For this reason infectious conditions must be excluded in a case with CLL and fever. Richter's transformation (RT) is a kind of lymphoma that is a rare condition in CLL cases Fever of unknown origin is a rare finding in Richter's transformation (RT) but it has been reported as anecdotal reports. Here a case with RT as the cause of fever in a case with CLL was reported and literature was reviewed

Modeling the economic impact of pandemic influenza: A case study in Turkey

PubMedID: 20433052Influenza pandemics have occurred intermittently throughout the 20th century and killed millions of people worldwide. It is expected that influenza pandemics will continue to occur in the near future. Huge number of deaths and cases is the most troublesome aspect of the influenza pandemics, but the other important trouble is the economic impact of the influenza pandemics to the countries. In this study, we try to detect the cost of a possible influenza pandemic under different scenarios and attack rates. We include the vaccination and antiviral treatment cost for direct cost and we add the work absenteeism cost to the calculations for indirect cost of influenza pandemics. As a case study, we calculate the economic impact of pandemic influenza for Turkey under three different scenarios and three different attack rates. Our optimistic estimation shows that the economic impact of pandemic influenza will be between 1.364 billion dollars and 2.687 billions dollars to Turkish economy depending on the vaccination strategies. © Springer Science + Business Media, LLC 2008

Are the comments on HaNDL syndrome in the ICHD-II sufficient? [ICHD-II'ya göre HaNDL sendromunun yorumlari{dotless} yeterli mi?]

A 33-year-old man was admitted to our emergency department for severe frontal headache followed by a state of consciousness disturbance and right-sided hemiparesis. No previous febrile disease, head trauma, vascular risk factor, and medication for any systemic disease were defined in his history. He had experienced a similar disorder three years ago and had recovered completely. Cerebrospinal fluid (CSF) analysis revealed pleocytosis and electroencephalography (EEG) showed diffuse slow wave activity. Hyperintense foci on T2 and FLAIR sequences representing bilateral cortical ischemia, prominent on the right hemisphere, were seen on MRI. Contrast-enhanced T1 images showed marked leptomeningeal thickening with enhancement. The patient was considered as having CSF lymphocytosis (HaNDL syndrome) due to temporary headache with neurologic deficit and CSF pleocytosis. Diagnostic criteria have been identified for this syndrome according to the International Classification of Headache Disorders, 2nd edition (ICHD-II). According to these criteria, neuroimaging should be normal. Positive neuroimaging findings and impairment of consciousness have been reported in a limited number of HaNDL cases so far. Diversity of neurological signs, duration and distinctness from migraine headache have been described in comment section under the diagnostic criteria. Comments are inadequate in this regard. © Archives of Neuropsychiatry

A case of myocarditis mimicking acute coronary syndrome associated with H1N1 influenza A virus infection

PubMedID: 21248460Myocarditis due to H1N1 influenza infection has not been previously described. We report on a case of acute fulminant myocarditis caused by H1N1 influenza A virus infection that mimicked acute coronary syndrome. A 50-year-old man was admitted with dyspnea, fever, cough, vomiting, and atypical chest pain of three-day history. His body temperature, pulse rate, and blood pressure were 39.2 °C, 115 beats/min, and 80/40 mmHg, respectively. Electrocardiography showed sinus tachycardia, 1-mm ST-segment elevation, and absence of R wave progression in anterior leads, and ST depression in anterolateral leads. The chest radiogram revealed diffuse bilateral alveolar infiltrates. Cardiac enzymes were elevated. Despite treatment with aspirin, clopidogrel, low-molecular weight heparin, metoprolol, and an ACE inhibitor, he developed hemodynamic instability on the first day of admission. Echocardiographic examination showed anteroseptal, apical, and lateral wall hypokinesia, left ventricular diastolic dysfunction, and dilatation of all the chambers. There was no abnormal finding on coronary angiography. The diagnosis was considered to be myocarditis; thus, anticoagulant and antiaggregant therapies were discontinued, and empirical broad-spectrum antimicrobial treatment was initiated together with antiviral oseltamivir (2x75 mg/day). The patient's clinical condition significantly improved. Nasopharyngeal samples were positive for H1N1 influenza A virus. He was discharged on the 15th in good medical condition

A significant interaction between moxifloxacin and warfarin in a patient with a mitral bioprosthetic valve

PubMedID: 18649061Moxifloxacin is an advanced-generation fluoroquinolone with a broad spectrum of antimicrobial activity that is not metabolized by cytochrome P450 system. Therefore, the drug interaction of moxifloxacin is rarely seen. It has been reported that moxifloxacin is safe and well tolerable. We aimed to report a drug interaction between moxifloxacin and warfarin in a 74-year-old patient with a prosthetic mitral valve. © Springer Japan 2008