Biomedical subjects
Publications and source records attributed to E U Schmid.
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Explore the source record for details and available documents.
Twenty-four patients with advanced epidermoid carcinoma of the esophagus were treated with trimetrexate (TMTX), a lipid soluble non-classical antifol. Patients were given TMTX 8 mg/m2 intravenously day 1-5 every 28 days. In nine of these patients the dose was escalated to 12 mg/m2 day 1-5 every 28 days. Three patients had a partial response (95% confidence limit 3-32%) with a median response duration of 14 weeks. No hematologic toxicity was documented. Two patients developed moderate stomatitis and only 3 patients experienced any nausea or vomiting. The median survival of all patients is 12 weeks. It is concluded that a higher dose of TMTX should be studied in patients with esophageal cancer in order to assess the true therapeutic value of the agent at a dose closer to the median tolerated dose. A phase II ECOG study using TMTX 12 mg/m2 intravenously day 1-5 every 21 days is currently being conducted.
A practical approach to the patient with pain in the right fossa iliaca is presented, stressing the importance of a clinical diagnosis. It is essential to select patients in need of urgent surgery, e.g. those with ectopic pregnancy, ruptured abdominal aneurysm, and perforated viscus, but not to operate on patients in whom surgery may be detrimental, e.g. those in diabetic precoma, or those with porphyria and pneumonia.