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Biomedical subjects

J Ferris

Publications and source records attributed to J Ferris.

At least 19 recordsLinked to original sources

Acute nonlymphoblastic leukemia in children treated for acute lymphoblastic leukemia with an intensive regimen including teniposide.

Some cases of conversion from acute lymphoblastic leukemia (ALL) to acute nonlymphoblastic leukemia (ANLL) at relapse have been reported recently. We report three cases initially diagnosed as having ALL and showing morphological, cytochemical, and immunophenotypic features of ANLL at relapse (lineage switch). Conversion was observed among 14 patients who developed bone marrow relapse while undergoing intensive treatment with our ALL protocol, which includes teniposide, and that had been administered to 62 patients. The three cases converted at first relapse, with a mean time of 20 months (13-29 months). Clinical and immunologic characteristics of T-cell leukemia were present in one patient. Changes documented in cytogenetic studies are discussed. The underlying mechanisms for the lineage switch remain unclear as does its relation with mixed lineage leukemias, but we believe that drugs employed in our therapy protocol could have had an influence on this conversion.

Child, Preschool

Pride.

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Education, Veterinary

Hepatosplenic candidiasis in children with acute leukemia.

Three children with acute lymphoblastic leukemia developed disseminated fungal disease predominantly involving the liver and spleen. The three patients were undergoing induction chemotherapy and had neutropenia when they presented prolonged fever not responsive to antibiotics. Once neutropenia was recovered, hepatosplenomegaly leukocytosis, elevated serum alkaline phosphatase, and hypoechoic areas in the spleen and liver ultrasound were observed. All fungal blood cultures were negative, with the diagnosis being confirmed by histologic study. One of the patients died without achieving control of the candidiasis. The other two patients received prolonged antifungal treatment concurrently with chemotherapy and both are alive, one of them cured and in complete remission. The increasing frequency of this infection in recent years and the importance of a prompt and prolonged administration of antifungal therapy to obtain the cure are discussed.

Antifungal Agents

[Neonatal tumors].

We review the cases of congenital and neonatal tumors treated at the Children's Hospital La Fe, Valencia. A total of 25 cases of neonatal benign tumors and 27 cases of malignant tumors were diagnosed. The most frequent benign tumor was solid teratoma (12 cases). The most frequent malignant tumor was neuroblastoma (14 cases). Variations in histology, clinical evolution and therapy in relation to age are described. The results obtained are compared with those previously published.

Hospitals, Pediatric

Antibodies to denatured type II collagen in rheumatoid arthritis: negative association with IgM rheumatoid factor.

Serum samples from 129 patients with definite or classic rheumatoid arthritis (RA) were assayed by ELISA for antibodies to denatured bovine type II collagen (dII). All patients had active disease at the time of serum sampling. Anti-dII antibodies were found in 18 (14%) of 129 patients (95% confidence intervals: 8-20%). The only clinical or laboratory feature associated with the presence of anti-dII antibodies was seronegativity for IgM rheumatoid factor (IgM RF): 6 (37.5%) of 16 seronegative patients had anti-dII antibodies vs 12 (10.6%) of the 113 seropositive patients (OR = 5, p less than 0.01). There were no associations of anti-dII antibodies with age, sex, race, disease activity, disease duration, functional class, or the presence of HLA-DR1, DR4, or DQw3 in these patients. Antibodies to type II collagen may have a pathophysiologic role in RA, especially in patients seronegative for RF.

Adult

[Gammagraphy with 123I-meta-iodobenzylguanidine in the diagnosis of pheochromocytoma].

At times pheochromocytoma raises diagnostic problems which cannot be solved by methods already incorporated into diagnostic evaluation, such as catecholamine measurement, echography and computed tomography. These drawbacks are more common with small size tumors, malignant extra-adrenal pheochromocytoma and some cases of relapse after surgery. The present study reports the results of 123I-meta-iodobenzylguanidine (MIBG) scintiscan in 30 patients with suspected pheochromocytoma. The head, the thorax and the abdomen were scanned in all patients after 3, 24 and 48 hours. Areas of normal and abnormal uptake were evaluated in these areas. The scintiscan was positive in seven cases with a diagnosis of pheochromocytoma, which showed markedly increased uptake persisting throughout the study. The results of other studies are analyzed and the functional character of MIBG, its sensitivity and specificity, and the advantages of 123I over 131I are discussed.

3-Iodobenzylguanidine

Fine-needle aspiration biopsy in children: experience in 70 cases.

Results of 70 fine-needle aspiration biopsies (FNAB) were evaluated retrospectively in 61 pediatric patients. Over a period of 9 months all mass lesions suspected being malignant were aspirated. Twelve of the 70 aspirations were performed in children having known tumours, in order to exclude recurrence or metastasis. The others were carried out to obtain a diagnosis. Satisfactory specimens were obtained from 58 (83%). There were 21 benign diagnoses, 36 malignant diagnoses, and 1 with suspected malignancy. Correlation of histologic and cytologic diagnoses was possible in 45 cases. The diagnostic sensitivity and specificity were 95% and 80%, respectively. We have found FNAB more accurate in the diagnosis of malignancies than in benign lesions. The results suggest that this is a useful technique for obtaining a first diagnosis of malignancy, as well as for excluding recurrence or metastatic disease.

Adolescent

Esmolol in the treatment of supraventricular tachyarrhythmias.

Infusion of esmolol, an ultra short acting beta-blocker was used in the acute management of 48 patients with supraventricular tachyarrhythmias. Following acute control of the heart rate, patients received maintenance of esmolol infusion for 6 h when they were transferred to alternate oral antiarrhythmic agents. Prompt control of heart rate (mean +/- SD, 15 +/- 8.8 mins) was achieved in 85% of patients with esmolol at a dose rate of 80 +/- 59 micrograms/kg/min. Ninety percent of these subjects were successfully transferred to alternate oral therapy. Five subjects experienced transient side effects. Esmolol was highly effective and particularly suitable for the acute management of patients with supraventricular tachyarrhythmias.

Adrenergic beta-Antagonists

[Acute lymphoblastic leukemia of high risk: results of a therapeutic protocol].

Sixteen consecutive children diagnosed of "high risk" acute lymphoblastic leukemia were treated with a protocol including VM-26, ARC and intermediate-dose Mtx. Complete remission was obtained in 94 por 100 of patients. Actuarial haematologic remission rate at 36 months is 87% and continuous complete remission rate 58%. Twelve doses of Mtx (IV + IT) appear to be insufficient as SNC prophylaxis in these high risk children. Nevertheless hematologic relapse rate is very low. Mean follow-up time is 31 months and survival rate 87%.

Antineoplastic Combined Chemotherapy Protocols

[131I-MIBG-meta-iodobencylguanidine (131I-MIBG) in the study of neuroblastoma].

Ten patients with neuroblastoma were scintigraphed with I131-meta-iodobenzylguanidine (MIBG). Lugol solution was previously administered orally to all patients in order to avoid uptake of radioactive iodide by the thyroid gland. The compound was injected intravenously, 0.5 mCi/1.73 m2 of body surface. Scintigraphy was performed at 24, 48 and 72 hours and 6-7 days after administration of the radioactive preparation. Positive radiotracer uptake was demonstrated in all primitive tumors and metastases, showing a positivity of 100%. MIBG has proven to be the most useful technique in defining the stage of the disease. Mechanism of the tumoral uptake in relationship to catecholamine metabolism is discussed. Differences observed in MIBG radioactivity seen in the urinary bladder, heart and liver in children with or without. Neuroblastoma are discussed. MIBG has also been useful in the follow-up of patients with neuroblastoma.

3-Iodobenzylguanidine