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Biomedical subjects

G A Saab

Publications and source records attributed to G A Saab.

12 recordsLinked to original sources

Prolonged chlorpromazine infusion as antiemetic in patients on daily cisplatin infusion. A pilot study.

Continuous chlorpromazine infusion 120 mg/m2/24 h was administered for a period of 84-110 h to 24 consecutive patients with various advanced solid malignancies receiving concomitantly a 3-day infusion of cisplatin. The latter was given at a dose of 40 mg/m2/day over 6 h every day, in combination with either doxorubicin and cyclophosphamide or 5-fluorouracil infusion or vinblastine and bleomycin. This novel approach of using prolonged continuous chlorpromazine infusion as antiemetic therapy proved quite safe with no incidence of extrapyramidal toxicity, hepatotoxicity, or agranulocytosis. Only one episode of convulsions occurred, promptly reversed. Also, antiemesis was demonstrated in 66% of patients receiving such highly emetogenic chemotherapy. Blood levels of chlorpromazine did not correlate with antiemetic efficacy.

Adult

Breast carcinoma metastatic to the nasopharynx.

A case report of a patient with adenocarcinoma of the breast with metastasis to the nasopharynx is described. The patient presented initially with pulmonary metastasis followed later by metastasis to the left jugulo-digastric lymph nodes. A prominent but asymptomatic nasopharyngeal mass was concomitantly discovered on head and neck examination. Three months later, symptoms of panhypopituitarism developed. Invasion of the base of the skull and pituitary were documented. Patients with adenocarcinoma of the breast and high cervical node metastasis should have a thorough otolaryngologic and head and neck evaluation. Metastatic carcinoma to the nasopharynx is an extremely rare occurrence. Only two cases of bronchogenic carcinoma of the lung and two cases of hypernephroma metastatic to the nasopharynx have been reported in the literature (Bernstein et al., 1966). We present what we believe to be the first case of metastatic adenocarcinoma of the breast to the nasopharynx.

Adenocarcinoma

Ferritin synthesis by monocyte-derived macrophages in thalassemic patients with intrinsic iron overload.

Macrophage ferritin content was determined following culture of peripheral blood monocytes for a period of 8 d in 40% autologous plasma to render them mature macrophages. Ferritin content was measured prior to and following culture using the radioimmunoassay. The normal range of values was established in a group of 22 healthy volunteer blood donors. A significant increase in the ratio of macrophage/monocyte ferritin was observed in every donor studied (range 1.2 - 1.8, p less than 0.001). Also, a further significant increase was observed when these macrophages were additionally incubated for 6 h with heterologous antibody-coated sheep red blood cells (range 1.2 - 1.57, p less than 0.001). Finally, the same studies were performed on a group of thalassemic patients with and without intrinsic iron overload. Again there were significant increases in monocyte ferritin content following culture as well as ingestion of heterologous sheep red cells, with magnitudes similar to those obtained with normal donor monocytes. Therefore we could not demonstrate the presence of a cellular ferritin synthesis defect in macrophages of thalassemic patients with intrinsic iron overload to explain the uncontrolled absorption of dietary iron from their gut.

Cell Differentiation

Efficacy of continuous high-dose metoclopramide in patients receiving daily cisplatin infusions.

Continuous high-dose metoclopramide (MCP), 2 mg/kg/24 hours, was administered for a period of 84-90 hours to 30 consecutive patients with various advanced solid malignancies receiving concomitantly a 3-day infusion of cisplatin. The latter was given at a dose of 40 mg/m2/day over 6 hours every day, in combination with doxorubicin and cyclophosphamide. Diphenhydramine and dexamethasone were also administered. This prolonged antiemetic therapy proved to be safe with only a 16% incidence (five of 30 patients) of extrapyramidal side effects not necessitating discontinuation of MCP. Also, antiemetic efficacy was demonstrated with 63% of the patients not experiencing any emesis.

Adult

Graft-versus-host disease in lymphoblastic lymphoma following blood transfusions.

The case of a 20-year-old man with lymphoblastic lymphoma in leukemic phase succumbing to acute graft-versus-host disease (GVHD) following intensive chemotherapy and blood transfusions is described. Such a documented association has rarely been reported in the literature. The issue of irradiating blood components prior to transfusion in patients with suspected cell-mediated immunodeficiency receiving intensive chemotherapy is raised and discussed.

Adult

Rapid assay for measurement of serum ferritin.

The authors present a rapid modification of the tube immunoradiometric assay for serum ferritin quantitation. The method involves gentle rotatory mixing of the tube contents at ambient temperature and can be performed in a few hours. Variables affecting different stages of the assay were systematically investigated. The performance characteristics of the shortened assay in terms of reproducibility, sensitivity and recovery were then validated. Results with this method correlate well with those obtained by the conventional assay.

Ferritins