Thyroid cancer since the Chernobyl accident: a hypothesis.
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Global Health↗
Biomedical subjects
A Macheras
Publications and source records attributed to A Macheras.
Combined epirubicin, 5-fluorouracil and folinic acid vs no treatment for patients with advanced pancreatic cancer: a prospective comparative study.
The combination of 5-fluorouracil (5-FU) and folinic acid (FA) has demonstrated activity in most gastrointestinal tumors. The addition of epirubicin (EPI) may increase the efficacy of the combination for cancers of the upper gastrointestinal tract, such as advanced pancreatic cancer. We examined two groups of patients, explaining the potential benefits and limitations of therapy, and those patients who agreed to undergo chemotherapy formed Group A and the remaining formed Group B. Therefore, the study was a non-randomized prospective comparison between patients receiving chemotherapy and those offered the best supportive care. Group A consisted of 42 patients; 19 underwent Roux-en-Y operation, and 23 were inoperable. Group B consisted of 48 patients who refused chemotherapy; 18 underwent Roux-en-Y operation, and 30 were considered inoperable. Chemotherapy consisted of FA 200 mg/m2/day, 5-FU 600 mg/m2/day both for 5 days, and EPI 35 mg/m2/day before FA-5-FU administration on days 1 and 2, every 28 days. All patients were evaluable for response and toxicity. Objective tumor responses (partial responses) in Group A were seen in 8 patients (19%) (6 women and 2 men), and 6 (14%) had stable disease. The estimated median survival was 27.6 weeks (mean 27.5) for Group A and 22.5 weeks (mean 24) (p=0.01) for Group B. From the onset of therapy, median duration of response was 16.6 weeks and median time to progression 11.8 weeks in Group A. Toxicity consisted primarily of myelosuppression, nausea and vomiting, diarrhea, alopecia, and mucositis. In Group A 12/42 patients became free from pain for a median duration of 10 months, 14/42 had improved appetite, and 15/42 had improved performance status in comparison to Group B, where no patients had improved performance status or symptoms. We conclude that the combination of EPI+FA+5-FU has moderate activity and increased toxicity in the treatment of advanced pancreatic cancer.
Adult↗
Rupture of an abdominal aortic aneurysm following acute descending thoracic aortic dissection. Case report.
The coexistence of an abdominal aortic aneurysm and an acute aortic dissection seems to be rare and only a few reports are to be found in the literature. We report a case of a patient with acute aortic dissection of the descending thoracic aorta that caused rupture of a pre-existing abdominal aortic aneurysm. The literature is also thoroughly reviewed.
Acute Disease↗
Multiple cholesterol embolism: a case report.
Cholesterol embolism is an unusual but serious complication of intra-arterial procedure such as arterial catheterization, angiography, and angioplasty. In this short paper a case of fatal cholesterol embolisation after angiography is described. Histology examination revealed atheroembolic lesions in the kidneys, spleen and colon.
Aged↗
Effect of cefamandole, cefuroxime and cefoxitin on yeast fecal flora of surgical patients.
Aim of the present study was to evaluate the effect of cefamandole, cefuroxime and cefoxitin on the level of gastrointestinal (GI) colonization by Candida albicans in humans. Twenty-eight adult patients received one of these three cephalosporins for 10 days, as treatment of infection, and were studied prospectively. Quantitative stool cultures for yeasts were performed immediately before, at the end, and 1 week after discontinuation of treatment. All three antibiotics caused an increase of the yeast concentration in the fecal flora. The increase caused by cefoxitin was the highest (2.5 log10 CFU/g of stool). Our results suggest that the cephalosporins tested cause minor increases of the colonization of the GI tract by C. albicans.
Adult↗
Effects of cefepime and meropenem on the gastrointestinal colonization of surgical patients by Candida albicans.
BACKGROUND: The study evaluated the effects of cefepime and meropenem on the gastrointestinal (GI) colonization of surgical patients by Candida albicans. PATIENTS AND METHODS: Twenty adult surgical patients who received intravenously either of these antibiotics as monotherapy for the treatment of an existing infection were studied prospectively. Ten patients received cefepime (2.0 g twice a day), and another ten meropenem (1.0 g every 8 h) for 7 days. Quantitative stool cultures for C. albicans were performed immediately before, at the end, and 1 week after the end of antibiotic treatment. RESULTS: Both antibiotics increased the GI colonization of patients by Candida. Meropenem caused a higher increase (2.0 log(10) CFU/g of stool) as compared to cefepime (1.7 log(10) CFU/g of stool). However, these increases were statistically not significant. CONCLUSION: Cefepime and meropenem when given to sensitive patients do not increase significantly the risk of Candida infection originating in the GI tract.
Adult↗