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Biomedical subjects

J Mardiak

Publications and source records attributed to J Mardiak.

At least 37 records · Page 2Linked to original sources
PubMed1997

Bacteremia in cancer patients with solid tumors undergoing chemotherapy versus surgery: risk factors, etiology and outcome in 276 patients.

Etiology, risk factors, outcome and complications of bacteremia in 276 patients with solid tumors were analyzed. A group of 78 patients with solid tumors and surgical therapy only was compared with 172 patients with solid tumors who were treated with chemotherapy only. The most frequently observed risk factors of bacteremia in patients after surgery was urinary catheter insertion, wound as source of bacteremia, age > 60, staphylococci, enterococci and Enterobacteriaceae as etiologic agents. In comparison, viridans streptococci and Pseudomonas aeruginosa as etiologic agents as well as vascular catheters were significantly more frequently found in those treated with chemotherapy only. Patients with bacteremia after surgery only had a lower incidence of septic shock (6.4 vs. 16.9%, P < 0.03) and also lower mortality (5.6 vs. 14.9%, P < 0.04) attributable to shock than patients being treated for solid tumors with chemotherapy only.

Antineoplastic Agents↗
PubMed1997

Bacteremia in neutropenic versus nonneutropenic cancer patients: etiology and outcome in 401 episodes.

Etiology, risk factors, symptomatology and outcome of 401 bacteremic episodes during the period of 6 years in a National Cancer Institute occurring among 9987 admissions were analyzed. Neutropenia as an independent risk factor was observed in 198 episodes, while 203 bacteremic episodes appeared in nonneutropenic patients. Both groups were compared in risk factors, etiology, clinical symptomatology and outcome. Proportion of particular pathogens did not show significant differences in both groups, except for E. faecalis occurring more frequently in the group of nonneutropenic patients in contrast to Enterobacteriaceae, occurring more frequently in neutropenic patients. There was significant by higher proportion of anaerobic bacteremia and fungemia in neutropenic than in nonneutropenic patients. Prior prophylaxis with quinolones with breakthrough bacteremia were also seen more frequently in the group of neutropenic patients. Septic shock and death due to bacteremia occurred more frequently in the group of neutropenic patients.

Adult↗
PubMed1996

Invasive mold infections in cancer patients: 5 years' experience with Aspergillus, Mucor, Fusarium and Acremonium infections.

Twenty systemic mold infections due to hyphic fungi (molds) arising within the last 5 years in a 60-bed cancer department are analyzed. The most frequent risk factors were plants in ward (75%), prior therapy with broad spectrum antibiotics (70%), catheter insertion (70%), acute leukemia (65%) and neutropenia (60%). Before death, a definitive diagnosis was made in 40%, and a presumptive diagnosis in 60% of patients: post mortem the presumptive antemortem diagnosis was confirmed in all cases (100% of patients). Aspergillosis was the most common invasive fungal disease (55%), followed by mucormycosis (15%), fusariosis (15%), and acremoniosis (10%). Of 20 patients, 8 (40%) were cured or improved after antifungal therapy with amphotericin B, ambisome and/or itraconazole; 8/20 (40%) died of fungal infection and 4/20 (20%) of underlying disease with fungal infection. Even though the diagnosis was made and antifungal therapy started before death in 15/ 20 (75%), invasive mold infection had a 60% overall mortality in patients with malignant disease.

Acremonium↗
PubMed1996

Breakthrough bacteraemic and fungaemic episodes during antimicrobial prophylaxis and therapy in cancer patients: analysis of risk factors, etiology, therapy and outcome in 123 episodes.

One hundred twenty three breakthrough bacteraemias (BB) during 5 years in a National Cancer Institute, among 9986 admissions and 979 bacteraemic episodes were analysed. 123 BB were caused by 323 microbes, only 116 were resistant (31.5%) to currently administered antimicrobials. Sixty seven of 123 bacteraemic episodes were catheter associated confirmed by isolation of the same organisms from the blood and catheter tip. 77/123 BE were polymicrobial. The most frequently isolated strains were coagulase negative staphylococci (30.5%), Corynebacteria (10%), Ps. aeruginosa (10%), Str. faecalis (9%) and Viridans streptococci (8.5%). Gram-positive aerobes accounted for two-thirds of all organisms isolated during breakthrough bacteraemic and fungaemic episodes. Mixed polymicrobial breakthrough bacteraemic and fungaemic episodes were more frequently associated with vascular catheter insertion and neutropenia, and had a less favourable outcome in comparison to monomicrobial infections. The relapse was associated more frequently with catheter related bacteraemic and fungaemic episodes, but the overall mortality rate was similar independently from catheter insertion. Breakthrough bacteraemic and fungaemic episodes were associated more frequently with acute leukaemia. Polymicrobial breakthrough bacteraemic and fungaemic episodes were associated more frequently in neutropenic episodes and in venous catheters. Regarding the outcome, an extraction of the catheter with no dependence on variable and modification of antimicrobial therapy were essential for the improvement in the prognosis. (Tab. 5, Ref. 20.).

Antibiotic Prophylaxis↗
PubMed1993

Fluconazol plus ofloxacin in prophylaxis of infections in patients with acute leukemia: a comparative study.

In a retrospective study the incidence of infections, number of afebrile days, duration of antimicrobial chemotherapy, and cost of antibacterials and antimycotics were compared in two groups of patients. One was a group of 57 patients who received no prophylaxis during induction remission therapy of acute leukemia treated in 1989-1990, the second was a group of 22 patients treated in 1991 where prophylaxis with fluconazol and ofloxacin was administered. For ethical reasons pertaining since 1991, when prophylaxis became mandatory, the study was not randomized. A decrease in the number of febrile days, the cost of antimicrobials and the duration of treatment with antibiotics and antimycotics was observed in the group receiving fluconazol and ofloxacin.

Adult↗
PubMed1992

Netilmicin plus ceftriaxone versus amikacin plus ceftriaxone in the treatment of infections in granulocytopenic patients.

For the treatment of febrile episodes in granulocytopenic cancer patients, a combination of bactericidal and intravenously administered broad spectrum agents is recommended. An aminoglycoside plus a beta-lactame (piperacillin, azlocillin or IIIrd generation cephalosporins) are the drugs of first choice in an empiric approach. Because of frequent parenteral interventions (e.g. catheters, cannulations) in thrombopenic patients with multifactorial immunosuppression, we consider the application of once daily drugs, such as ceftriaxone, netilmicin or amikacin. For single dose treatment (1st day two applications), we used ceftriaxone in combination with netilmicin or amikacin as the first approach and retrospectively evaluated 47 patients for efficacy and safety.

Adult↗
PubMed1992

Intensive combination chemotherapy (TTL-I protocol) of large cell and immunoblastic lymphomas--long-term observation.

Fifty patients with advanced (Stage III and IV) large cell and immunoblastic lymphoma were treated with eight 4-week courses of chemotherapy. The first two identical A courses were composed of high dose cyclophosphamide, vincristine, 5-day administration of bleomycin, 2-week prednisone, and methotrexate with calcium leucovorin. The next two "B" courses were composed of vincristine, 3-day administration of doxorubicin together with bleomycin, and prednisone. The next two "C" courses were composed of cyclophosphamide, vincristine, bleomycin, prednisone, methotrexate, and calcium leucovorin. The last two "D" courses were the same as "B" courses. CNS prophylaxis was done with intrathecal methotrexate. Fourty-two patients (84%) achieved complete remission, 7 patients entered partial remission, and 1 patient failed to respond. The median survival of all groups was 80 + months (range 2-181 + months). Nine patients relapsed (21%), and seven patients died in complete remission, three of them died of toxicity. The most frequent toxicity was myelosuppression, mostly leukopenia, frequently followed by infection, sometimes severe. Neurotoxicity and stomatitis were frequent, but usually not severe. Two patients developed secondary malignancies. Most of the patients (54%) are alive without evidence of disease at present.

Adult↗
PubMed1991

[Various antibiotics in the monotherapy and combined therapy of infections in cancer patients. Retrospective study of 290 patients].

The authors present in a retrospective study the results of treatment of infections in 290 immunodeficient patients, mostly with haematological malignancies. As compared with classical empirical combined treatment (aminoglycoside + IIIrd generation cephalosporins), combinations of quinolones and amoxycillin, amoxycillin clavulanate or vancomycin proved more satisfactory.

Anti-Bacterial Agents↗
PubMed1991

Fluconazole in the treatment of mycotic oropharyngeal stomatitis and esophagitis in neutropenic cancer patients.

The efficacy and safety of fluconazole, a new triazole antifungal agent, was evaluated in 24 patients with neutropenia due to cytotoxic anticancer chemotherapy with polyfactorial immunodepression. Twenty of 23 patients benefited from treatment, and except for 1 patient with mild abdominal discomfort the drug was well tolerated. Mycological eradication appeared in 17 from 23 evaluable patients, superinfection in 1 case and persistence could be evaluated in 5 cases. Candida albicans, C. crusei and C. pseudotropicalis together with Torulopsis sp. were the most frequently isolated organisms from pharyngeal and esophageal mucosa in treated patients with oropharyngeal and esophageal mycosis.

Administration, Oral↗
PubMed1991

Comparison of two non-cross-resistant combinations (ABVP/LOPP) with COPP plus bleomycin in the treatment of advanced Hodgkin's disease.

Eighty patients with advanced Hodgkin's disease were randomized either to treatment with combination of doxorubicin, bleomycin, vinblastine, and prednisone (ABVP), alternating with lomustine, vincristine, procarbazine, and prednisone (LOPP)--Group A, or to combination of cyclophosphamide, vincristine, procarbazine, prednisone, and low dose of bleomycin (COPP-Bleo)--Group B. Thirty-nine out of 41 patients (95%) in Group A achieved complete remission (CR) as compared to 25 CR in 39 patients (64%) in Group B. Patients with systemic symptoms, bulky disease, and nodular sclerosis achieved significantly more CR after treatment with ABVP/LOPP regimen than with COPP-Bleo regimen. Ninety percent of patients are alive in Group A (median observation time 97+ months) as compared to 58% in Group B (median observation time 97+ months). Ninety-two percent of complete responders are in CR in Group A as compared to 53% of complete responders in Group B. These differences between both groups are significant. More serious (WHO grade III and IV) myelosuppression as well as stomatitis and alopecia were observed in Group A. Gastrointestinal toxicity and neurotoxicity was more frequent in Group A. No patient died due to toxicity in Group A as compared to one patient in Group B. Non-cross-resistant alternating regimen ABVP/LOPP was more effective in the treatment of advanced Hodgkin's disease than the COPP-Bleo regimen, especially for patients with advanced Stage IVB Hodgkin's disease.

Adolescent↗
PubMed1991

Determination of suramin in clinical samples using HPLC.

High-performance liquid chromatography (HPLC) was applied for the determination of suramin levels in serum samples from cancer patients treated with this drug. Ion-pair chromatography in combination with the deproteination procedure extraction and hydrolysis of complex serum proteins-suramin were recommended. Extraction recoveries and linearity for wide concentration range were evaluated. Detection limit of suramin in serum samples was determined (0.5 micrograms/ml), and concentration curves as the dependences of suramin concentration levels and time have been illustrated. Chromatographic conditions were optimized for minimal analysis time (max. 10 min) and suitable chromatographic resolution (Rij greater than 1.25).

Antineoplastic Agents↗
PubMed1990

[Peroral ciprofloxacin in the therapy of infections in oncology patients].

The authors give an account of their initial experience with oral ciprofloxacin (Ciprinol) in the treatment of various infections in 28 immunosuppressed oncological patients. A favourable effect--cure and improvement--were recorded in 72% of all treated patients. Unfavourable side-effects were observed in 4 of 28 patients, in two they were the reason for discontinuation of treatment.

Adolescent↗
PubMed1989

Treatment of advanced Hodgkin's disease with modified MOPP regimens. A long-term observation.

Fifty-three patients with advanced Hodgkin's disease, most of them previously treated, received 8 to 16 courses of modified MOPP regimens (nitrogen mustard replaced by trichlormethine in arm A, with addition of vinblastine to the 4-drug regimen in arm B, and alternation of three drugs--trichlormethine, vincristine, and prednisone--with probably non-cross resistant two drugs--vinblastine and procarbazine in arm C). Thirty patients (57%) achieved complete remission. Higher complete remission rate and longer survival was recorded in patients treated with 5-drug regimens (arms B and C) as compared to the 4-drug regimen (arm A), but the differences were not significant. Higher complete remission rates were observed in asymptomatic patients, females, and patients with lymphocyte predominance and nodular sclerosis subtypes of Hodgkin's disease. Besides expected short-term toxicity, 4 out of 30 complete responders developed secondary malignancies (two acute myeloblastic leukemias, one hepatocellular carcinoma, and one cerebellar astrocytoma). Several other patients had serious toxicity which could be attributed to chemotherapy. Twenty-eight percent of the patients has been alive 15 to 18 years since the start of this study.

Adolescent↗
PubMed1986

The value of the short term predictive assay in the inductive treatment of patients with acute nonlymphoblastic leukemia.

Predictive capacity and clinical usefulness of the short term predictive assay (STPA) in the inductive treatment of patients with acute nonlymphoblastic leukemia (ANLL) was studied. Inductive treatment consisted of daunorubicin, arabinoside C and 6-thioguanine (TAD regimen). Leukemic cells of 20 previously untreated patients with ANLL were incubated in vitro with two doses of daunorubicin (1 microgram/ml and 10 micrograms/ml), arabinoside C (10 micrograms/ml and 100 micrograms/ml) and 6-thioguanine (10 micrograms/ml and 100 micrograms/ml). The 3H-thymidine as well as 3H-uridine uptake was measured in the treated and untreated cells. The highest predictive presence of the in vivo drug-sensitive disease was adequately reflected by the level of 3H-uridine incorporation suppression 30% of control value in the case of daunorubicin (concentration: 10 micrograms/ml) and 80% in the case of 6-thioguanine (concentration: 100 micrograms/ml). In the case of arabinoside C (concentration: 10 micrograms/ml) the limit of 3H-thymidine uptake depression was 20% of control value. It was rather difficult to define the indicative degree of precursors incorporation inhibition for prediction of the drug-resistant disease, because of low number of patients primary resistant to TAD regimen. No correlation was found between the degree of the pre-treatment DNA synthesis rates and the precursors uptake inhibition by the tested drugs.

Antineoplastic Agents↗
PubMed1984

Malignant Leydig-cell tumour of testis.

A rare case of a malignant Leydig-cell tumour of the testis in a 26-year-old patient, with radical orchiectomy from an inguinal incision is described. Although the results of AFP, HCG, biochemical, X-ray, lymphographic and scintigraphic examinations were negative, the first metastases into the lungs appeared one year after the operation. Combined cytostatic treatment, polychemotherapy and X-ray therapy proved ineffective. The patient died of multiple metastases 28 months after the surgical intervention.

Adult↗
PubMed1981

Inhibition of colony-forming cells from bone marrow of leukemic patients by 3-oxauracil.

An in vitro system of colony forming cell inhibition was used for evaluation of 3-oxauracil (2,3-dihydro-1,3-6H-oxazine-2,6-dione) effectivity against bone marrow cells from 18 leukemic patients. The highest inhibitive activity of the 3-oxauracil was found in cases of acute lymphoblastic leukemia, comparing with bone marrow cells from patients with acute myeloblastic and chronic myeloid leukemia. According to the morphological characteristics of the formed colonies, lymphoblastic leukemia cells could be discerned from the myeloblastic ones in this system.

Antimetabolites↗