PubMed Health⌕ Search

Biomedical subjects

E Scheiner

Publications and source records attributed to E Scheiner.

15 recordsLinked to original sources
PubMed1987

Altered renin and aldosterone excretion in patients treated for metastatic germ cell tumours.

Twenty-four patients with metastatic germ cell tumours were studied for abnormalities in the renin-aldosterone axis and for persistent abnormalities of renal function 9+ to 54+ months following completion of cisplatin based chemotherapy. Increased plasma renin activity and aldosterone were identified in fourteen of nineteen (79%) patients. The mean serum magnesium was subnormal. Statistically lower serum phosphorus levels, and higher urea and creatinine levels were also observed. No patients was hypertensive or on diuretics at the time of study. Since vascular toxicity has been reported after cisplatin based chemotherapy and hypomagnesaemia and increased plasma renin activity have been linked to cardiovascular events, these data imply that germ cell tumour patients treated with cisplatin based chemotherapy should be carefully observed for delayed cardiovascular toxicity.

Aldosterone↗
PubMed1986

Increased plasma renin and aldosterone in patients treated with cisplatin-based chemotherapy for metastatic germ-cell tumors.

Twenty-four normotensive males in complete remission (CR) for 9+ to 54+ months after cisplatin-based chemotherapy for metastatic germ-cell tumors were evaluated for evidence of alterations in the renin-aldosterone axis and renal function. Abnormally high ambulatory plasma renin activity was seen in 14 of 19 patients with 24-hour urine sodium excretion greater than 50 mEq. This was correlated with elevated ambulatory plasma aldosterone (P = .009) and 24-hour urinary aldosterone excretion (P = .01). The mean serum magnesium value (1.34 +/- .05 mEq/L) was subnormal. Therapy resulted in an increase in serum creatinine during treatment (P less than .0001), an increase in BUN (P less than .01), and decrease in serum phosphorus (P less than .001). The relationship between the alterations in the renin-aldosterone axis and abnormal renal tubular function remains to be determined. In view of reports of cardiovascular toxicity after treatment for germ-cell tumors, and evidence individually linking both magnesium deficiency and increased plasma renin activity (PRA) to cardiovascular consequences, these abnormalities in renin and magnesium metabolism suggest that patients treated with cisplatin-based chemotherapy should be carefully observed for the development of delayed cardiovascular toxicities.

Adult↗
PubMed1984

Tonsillectomy--some like it hot.

Methods of tonsillectomy using electrocautery for dissection and hemostasis are gaining popularity. A prospective, controlled, randomized, single blind study was designed to compare this method to tonsillectomy performed by scissor dissection with suture hemostasis. In general, tonsillectomy by electrocoagulation was found to reduce operative time and blood loss, and to increase postoperative pain and prolong healing. Overall morbidity in the study was low, and no significant differences in complications, e.g., bleeding were noted.

Anesthesia, General↗
PubMed1980

Microangiopathic anemia observed after treatment of epidermoid carcinoma with mitomycin C and 5-fluorouracil.

Two patients with epidermoid carcinoma treated with mitomycin-C (Mit-C) and 5-fluorouracil (5-FU) developed microangiopathic hemolytic anemia (MAHA), renal failure, and altered mental status. Patient 1 was free of metastatic disease, on maintenance Mit-C and 5-FU when MAHA changes appeared. Patient 2 had recurrent carcinoma in the pelvic area when MAHA changes appeared. In both patients, MAHA changes and neurologic function improved after exchange plasmapheresis. This is the first report of epidermoid carcinoma manifesting MAHA changes after chemotherapy. Speculation as to pathogenesis and appropriate therapy are discussed.

Anemia, Hemolytic↗
PubMed1979

Nephrotoxic antibiotics in patients with renal failures: guidelines for debilitated patients.

Fifty-seven cancer patients, who had had an 8--15% loss of body weight in the previous 6 months, were studied to establish the reliabity in wasted individuals of presently available nomograms correlating serum creatinine with creatinine clearance. Other predictors of renal function, such as osmolar clearance, free water clearance, and excreted fraction of filtered sodium, were also considered. In all patients, and especially in those with a measured creatinine clearance 10--50 ml/min, the use of standard nomograms based on serum creatinine resulted in gross overestimation of renal function. None of the other tests of renal function proved reliable for clinical purposes. It is concluded that in wasted patients administration of nephrotoxic drugs that are renally excreted should be adjusted to measured creatine clearance. Using other common predictors of renal function may result in overdosage.

Aminoglycosides↗
PubMed1977

High dose cis-platinum diammine dichloride: amelioration of renal toxicity by mannitol diuresis.

A clinical trial was undertaken to improve the therapeutic index of cis-platinum diammine dichloride with a concomitantly administered mannitol induced diuresis. Sixty patients, heavily pretreated, were entered; fifty-one are evaluable. The technique of concomitant osmotic diuresis and CPDD administration is described in detail. Doses ranged from 3 mg/kg to 5 mg/kg. At 5 mg/kg, dose-limiting renal, marrow and ototoxicity were seen, and resulted in one drug death. Marrow toxicity was moderate. Renal toxicity was limited to transient elevations in serum creatinine levels, except in some patients who had renal impairment prior to CPDD treatment. These patients had moderate renal toxicity. Serial treatments as frequently as once every 3 weeks were used to maintain responses. Serial high dose CPDD produced only mild renal dysfunction. Ototoxicity, usually subclinical, was quantitated audiometrically, and found to be dose related, but not clinically prohibitive at 4 mg/kg or less. The overall response rate (PR/MR) was 42%. Clinically significant responses in epidermoid carcinoma of the head and neck, adenocarcinoma of the ovary, and germ cell tumors of the testis were seen. All six responding patients with germ cell tumor of the testis, had been resistant to low dose (1mg/kg) CPDD. Two responding patients with ovarian adenocarcinoma had been resistant to alkylating agents.

Adenocarcinoma↗
PubMed1976

Acute renal failure after ligation of the hepatic artery.

Acute renal failure developed in nine of 78 patients who were subjected to hepatic artery ligation for nonresectable and extensive malignant tumor of the liver. Of those nine, six had hepatomas, one cholangiocarcinoma, one metastatic islet-cell carcinoma and one metastatic melanoma. Preoperative renal function as reflected in blood-urea-nitrogen and serum creatinine values was within normal limits. There were marked elevations of serum glutamic-oxalacetic transaminase and lactic dehydrogenase levels after hepatic artery ligation, an indication of massive ischemic injury of the tumor and the liver. A diagnosis of acute renal failure was established within 14 to 70 hours after hepatic artery ligation. In five patients, oliguric renal failure developed, and in four, high urinary output renal failure. In only three patients did systemic hypotension and hypovolemia precede acute renal failure. Seven of the nine patients died. Postmortem examination was done in five patients, and in only two was there evidence of renal tubular necrosis. The factors contributing to acute renal failure appear to be extensive involvement of the liver by tumor, presence of ascites and jaundice, occlusion of the portal vein and hyperuricemia. The presence of any one of the foregoing contraindicates the procedure.

Acute Kidney Injury↗