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Biomedical subjects

A C Yeomans

Publications and source records attributed to A C Yeomans.

11 recordsLinked to original sources
PubMed1993

Phase I and plasma pharmacokinetic study of infusional fluorouracil combined with recombinant interferon alfa-2b in patients with advanced cancer.

PURPOSE: Enhanced fluorouracil (FUra) cytotoxicity caused by recombinant interferon alfa-2b (rIFN-a) has been reported, but the mechanism, optimal dose, and schedule remain unknown. Therefore, a phase I and pharmacokinetic study of FUra with escalating doses of rIFN-a was initiated. PATIENTS AND METHODS: FUra (750 mg/m2/d) was given by continuous intravenous (IV) infusion for 5 days. rIFN-a (0.1 to 15 x 10(6) U/m2/d) was given subcutaneously (SC) daily for 5 days concurrent with FUra. Courses were repeated every 14 to 21 days. Forty-four patients were enrolled; 39 received at least two courses. During the first course of therapy, FUra levels before and after administration of rIFN-a were quantitated in 26 patients by high-pressure liquid chromatography. RESULTS: The maximum-tolerated dose of rIFN-a was 10 x 10(6) U/m2/d. Stomatitis was dose-limiting. Three partial and five minor responses occurred. Interpatient pharmacokinetics showed that rIFN-a did not alter steady-state plasma concentration (Css; range, 0.77 +/- 0.35 mumol/L to 1.85 +/- 0.48 mumol/L), elimination half-life (t1/2; mean, 9.7 +/- 4.3 minutes), area under the concentration-versus-time curve (AUC; range, 93 to 224 mumol/L x hours), total-body clearance (CI; range, 1,172 to 3,236 mL/min), or volume of distribution (range, 11.9 to 49.2 L) of FUra. Intrapatient data evaluation revealed a dose-independent effect of rIFN-a. The mean FUra Css after rIFN-a administration (1.31 mumol/L) was greater than that before rIFN-a administration (1.02 mumol/L, P < .0001). FUra Cl after rIFN-a administration was reduced by 20% to 35% compared with use of FUra alone (P < .0001). Patients with a greater than 20% decrease in FUra Cl had a fourfold greater incidence of diarrhea. CONCLUSION: rIFN-a reduces FUra Cl and, consequently, increases FUra-associated toxicity. Phase II studies of FUra and rIFN-a seem to be warranted.

Adult↗
PubMed1991

Occult primary malignancies.

Occult primary malignancies (OPMs) are the eighth most common cancer in the United States. Generally, the prognosis is poor, with survival usually lasting two to four months from the time of diagnosis. The primary tumor will never be found in more than half of the patients, even after an exhaustive diagnostic workup and eventual autopsy. The majority of these tumors are metastatic at the time of diagnosis; therefore, therapy is palliative. Nursing implications include providing symptom management, psychological support, and patient education.

Clinical Protocols↗
PubMed1991

Assessment and management of gouty arthritis.

Gout is a metabolic disorder of purine metabolism that leads to elevated serum concentrations of uric acid. When this happens, urate crystals may precipitate and accumulate in the joints and bursae. Gout is characterized by recurrent, painful attacks of arthritis, which is the major clinical complication of the disease. Early diagnosis and treatment of gout are important to prevent complications, and with early, sustained therapy, most patients can live without functional disability. If gout becomes chronic, individuals may experience severe limitations of activity. This article discusses the clinical manifestations, diagnosis and treatment of acute and chronic gout.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1990

Myelodysplastic syndromes.

A cure for MDS has yet to be found. The aim of therapy is to attempt to restore normal hematopoiesis and prevent evolution to acute leukemia. The major trend is supportive care. Blood counts and bone marrow aspirations are taken to evaluate the disease, and transfusions of blood products and antibiotics are given when necessary. A new encouraging modality of therapy is the use of hematopoietic growth factors to reverse cytopenias. As there is no curative treatment for MDS, the patient is likely to be offered investigational drugs either singly or in combination. Future trends in the treatment of MDS will be combinations of agents including biological agents with retinoic acid or vitamin D, low-dose Ara-C, the interferons, and colony-stimulating factors.

Antineoplastic Agents↗
PubMed1990

Assessment and management of hypothyroidism.

Hypothyroidism is a hypoactive metabolic state associated with a deficiency in thyroid hormone metabolism. This condition affects many bodily systems, including the nervous system, circulatory system, muscular system, the heart and energy-producing system, and the endocrine glands. The goal of treatment for this hypometabolic state is replacement of thyroid hormones. Health care practitioners need to be aware of early signs and symptoms, and subsequent treatment and monitoring of patients with hypothyroidism.

Humans↗
PubMed1988

Ifosfamide and mesna: marginally active in patients with advanced carcinoma of the pancreas.

Ifosfamide, an analogue of cyclophosphamide, has therapeutic activity against a wide variety of human malignancies. In a phase II trial in carcinoma of the pancreas, we treated 31 patients who had not received prior chemotherapy with a median ifosfamide dose of 2 g/m2/d (range, 1.5 to 2 g/m2/d) administered intravenously (IV) over one hour for five consecutive days every 3 weeks. 2-mercaptoethane sulphonate (mesna), an acrolein antagonist with known uroendothelial protective properties, was administered IV at a dose of 400 mg/m2 over 15 minutes before the daily dose of ifosfamide and repeated every four hours for two additional doses. Among 30 evaluable patients, one patient achieved a complete remission (26+ months) and another patient had a partial remission (4 months). The median duration of survival of all patients from the start of ifosfamide therapy was only 3 months (range, 1 to 26+ months). Treatments were generally well tolerated. The most common toxic effects included granulocytopenia, nausea and vomiting, malaise, anorexia, and mild hematuria. Mesna offers an adequate protection against uroendothelial injury caused by ifosfamide. Despite the previously reported response rate of greater than 20% at the same or lower doses of ifosfamide in other studies, our data suggest that ifosfamide is only marginally active against cancer of the pancreas and appears to be of minimal value in the treatment of patients with this tumor.

Adult↗