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Biomedical subjects

H M Pretty

Publications and source records attributed to H M Pretty.

16 recordsLinked to original sources

Acute and delayed emesis after cisplatin-based regimen: description and prevention.

Lorazepam, dexamethasone and high-dose metoclopramide were given to 54 patients to prevent emesis induced by cisplatin (50-120 mg/m2) on day 1, while prochlorperazine and dexamethasone were administered on days 2 and 3 for control of delayed emesis. Nausea and emesis were recorded from day 1 to day 8. This combination was well tolerated. Prevention on day 1 was complete for 72% of patients and satisfactory (less than or equal to 2 emeses on day 1) in 85%. From days 2 to 8, no emesis, less than or equal to 2 and greater than 2 episodes occurred in 70, 11 and 19%, respectively. Overall control (days 1-8) was complete in 55.5% and satisfactory (less than or equal to 2 emeses on day 1 and/or less than or equal to 2 emeses from days 2 to 8) in 74%. Delayed emesis started on days 2-5. Mean duration was 2.6 days. Delayed nausea or emesis were more frequent when emesis occurred on day 1. Based on data previously reported and on these observations, better ways to prevent delayed events are discussed. Further trials must record systematically delayed side effects.

Acute Disease

Agranulocytosis: a report of 30 cases.

Thirty cases of acute agranulocytosis, as defined by Schultz, were observed between 1946 and 1964 at the Hôtel-Dieu Hospital, Montreal. In 14 cases agents incriminated were: aminopyrine, phenylbutazone, sulfonamides and chlorpromazine. Aminopyrine alone was responsible for eight cases. In the remaining 16 cases no definite etiology was established. Clinical manifestations included fever, prostration, angina and multiple pharyngeal ulcerations; these were associated with severe leukopenia and agranulocytosis. The bone marrow showed hypoplasia, lymphocytosis and maturation arrest. Localized and pulmonary infections, pseudomembranous enterocolitis and septicemia were frequent complications in 21 cases and were usually responsible for death, which occurred in 12 cases. Almost all patients who developed septicemia or pseudomembranous enterocolitis died. The pathogenesis is still not clear, but chlorpromazine and its analogues may act as a metabolic inhibitor, while the aminopyrine group probably operates through an immune mechanism.

Adult