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Biomedical subjects

J Feliu

Publications and source records attributed to J Feliu.

At least 73 records · Page 4Linked to original sources
PubMed1992

Comparison of two antibiotic regimens (piperacillin plus amikacin versus ceftazidime plus amikacin) as empiric therapy for febrile neutropenic patients with cancer.

A total of 170 febrile episodes in neutropenic patients with cancer were randomly assigned to be treated with piperacillin-amikacin or ceftazidime-amikacin. The overall response rates were similar in both groups (68 and 65%, respectively). Response rates for clinically or microbiologically documented episodes were 54.5% for piperacillin-amikacin and 58.8% for ceftazidime-amikacin. Response rates for gram-negative bacillary infections were 65 and 73%, respectively. There was also no difference for gram-positive infections (31 and 50%, respectively). The toxicities were also comparable and consisted of skin rashes, hypokalemia, and diarrhea. Vancomycin was added if the fever persisted 72 h after the beginning of therapy; it increased the response rates to 94% when used with piperacillin-amikacin and 92% when used with ceftazidime plus amikacin. Our results suggest that the combinations show similar global efficacies in the treatment of febrile episodes in cancer patients.

Adult↗
PubMed1991

[Lung cancer in patients under 40 years of age: a different problem?].

BACKGROUND: Less than 5% of the cases of lung cancer diagnosed are found in young patients. Although there are few studies concerning this problem it has been suggested that in this age group the behavior of the disease is more aggressive and the prognosis worse. METHODS: In order to study the clinical characteristics, histology, and evolution of bronchogenic lung cancer diagnosed in patients under 40 years of age the data of 56 patients with this neoplasm and age was compared with those obtained from 500 patients, equal to or over 40 years of age, diagnosed during the same period of time. RESULTS: The proportion of males/females among the patients under 40 years of age was 4:1, while in those patients over this age it was 13:1 (p less than 0.001). Epidermal cancer was the most frequent histological variety found among the patients over 40, while microcytic cancer of the lung was more frequent in those under 40 (p less than 0.05). In the group of patients under 40, 8 patients under 30 had special characteristics: male/female proportion 1:1 (p = 0.078), histological predominance of the adenocarcinoma variety and undifferentiated carcinoma of large cells (p = 0.008) and lower number of smokers (p = 0.035). The time of evolution of symptoms, the extension of the disease at the time of diagnosis and survival of the patients over or under the age of 40 was similar. CONCLUSIONS: Despite the presentation of special characteristics in young patients with bronchogenic lung cancer, the behavior of the disease is similar to that observed in other age groups.

Adenocarcinoma↗
PubMed1991

Alternating chemotherapy in advanced gastric cancer. A phase II study.

A phase II study with an alternating chemotherapeutic scheme, in advanced gastric cancer was conducted. Twenty-two patients were treated with cisplatin and mitomycin C on day 1 and BCNU and doxorubicin on day 28. Tegafur p.o. was given daily from the start to the end of chemotherapy. This scheme was repeated every four weeks. Response rate was 25% (2 complete and 3 partial). However, remissions were short lived, and median survival for the entire group was 7 months. Haematological and gastrointestinal toxicities were severe. In conclusion, the low response rate and the high toxicity of this regimen preclude its use for the treatment of gastric cancer.

Antineoplastic Agents↗
PubMed1991

Bone marrow examination in small cell lung cancer--when is it indicated?

To assess the usefulness of bone marrow (BM) examination performed as part of the staging procedure in SCLC, 137 patients with this neoplasm were studied. At diagnosis, BM was infiltrated in 23 patients (17%) and in 5 of them (22%) it was the only metastatic site. BM examination changed the previously given stage in 9% of the patients who were supposed to have limited disease before this test was performed. BM involvement correlated with a higher frequency of bone (p less than 0.05) and liver (p less than 0.01) metastasis. Correlations were found neither with blood or serum biochemistry disturbances nor with postchemotherapy haematologic toxicity. The BM positive patients had a survival rate similar to those with extensive disease but without BM infiltration. We conclude that BM examination should be performed only when no other metastatic sites have been found after a complete staging study.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Antiemetic regimens in outpatients receiving cisplatin and non-cisplatin chemotherapy. A randomized trial comparing high-dose metoclopramide plus methylprednisolone with and without lorazepam.

Results of a randomized trial on antiemesis for cisplatin (CDDP) and non-CDDP chemotherapy-induced vomiting are reported. One hundred and sixty-three outpatients received 282 chemotherapy courses (141 with CDDP and 141 without CDDP). Patients were randomly assigned to receive either high-dose metoclopramide plus methylprednisolone (arm A) or the same drugs plus lorazepam (arm B). In both arms a high protection rate for vomiting was obtained, on the whole without statistically significant differences. Patients who received lorazepam had, however, significantly fewer nausea episodes during first day post-chemotherapy (p less than 0.05). Arm B was also superior in anxiety control during the first day of chemotherapy (p less than 0.01). Both regimens were significantly more effective in patients who had not been given chemotherapy previously (p less than 0.01). No differences in antiemetic protection were found between CDDP and non-CDDP courses. No significant differences were found in premonitory vomiting control between the two arms of the trial. Toxicity was very mild with both regimens, although sedation was significantly higher in arm B (p less than 0.001). We conclude that high-dose metoclopramide plus methylprednisolone is a highly effective combination for chemotherapy-induced nausea and vomiting, and that it is quite suitable for outpatient use. Lorazepam did not significantly increase the antiemetic potency of the combination, nor did it improve premonitory vomiting control, although it gave a better control of acute nausea and anxiety.

Antineoplastic Agents↗
PubMed1991

[Plasma cell leukemia: our experience in 4 cases].

Clinical findings and response to treatment in four cases with plasma cell leukemia (PCL) out of 152 patients of multiple myeloma diagnosed at the Hospital La Paz from 1969 to 1988 are studied. Three of the four plasma cell leukemia cases presented a primary form, and one a secondary form. Our cases had a lower incidence of lymphadenopathy and splenomegaly than reported in previous series. The incidence of serum M band in PCL was similar to that found in multiple myeloma. The four patients received combination chemotherapy; one of them attained PR lasting for 2 months, and the remaining three failed to respond to similar therapy. The mean duration of survival was less than 8 months. Current treatments are reviewed.

Aged↗
PubMed1990

[Gastric adenocarcinoma following the treatment of a gastric non-Hodgkin's lymphoma].

The association of gastric non-Hodgkin's lymphoma (NHL) and the subsequent development of gastric adenocarcinoma is an exceptional finding. In our series of 24 cases of primitive NHL of the stomach diagnosed between 1966 and 1985 only one developed gastric adenocarcinoma. It was a 38-year-old male with a gastric NHL of immunocytoma type and in the stage IE of the Ann Arbor classification. The patient was treated with subtotal gastrectomy and adjuvant radiotherapy. Twenty-seven months later an adenocarcinoma of the gastrojejunal anastomosis mucosa was found. In the review of the literature we have found 17 cases of this association. Gastric adenocarcinoma developed 3.5-34 years after the treatment of gastric NHL. The implicated factors in the development of this association are: gastric resection, chemotherapy, radiotherapy and NHL itself.

Adenocarcinoma↗
PubMed1989

[Necrosis of the bone marrow and cancer].

Bone marrow necrosis (BMN) is a rare complication and is characterized by the presence of an eosinophilic amorphous material in the bone marrow. The clinical, analytical and histological characteristics of 4 patients with BMN associated to a neoplastic process are described. One of them was a gastric cancer but the neoplastic origin could not de determined in the other three cases. Three patients presented bone pain, but in all four patients thrombopenia, anemia, leuko-erythroblastic reaction and elevated LDH was found. A literature review is carried out and the possible physiopathological mechanisms are discussed.

Adult↗
PubMed1988

Acute leukemia and pregnancy.

Acute leukemia was diagnosed in five pregnant patients who received chemotherapy during the course of pregnancy. Three were undergoing chemotherapy at conception. One patient died in the fifth month of pregnancy and the anatomic study of the fetus was normal. Four babies had low birth weights at birth. Of the four one was born prematurely, but without malformations. Later development was normal. The results are reviewed and compared with data from the literature, leading to the conclusion that pregnancy is not an absolute contraindication for cytostatic treatment, except in the first trimester, in which cytostatic treatment should be avoided.

Adolescent↗