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Biomedical subjects

K Kane

Publications and source records attributed to K Kane.

13 recordsLinked to original sources
PubMed1992

Granulocyte colony-stimulating factor to prevent dose-limiting neutropenia in non-Hodgkin's lymphoma: a randomized controlled trial.

The effect of granulocyte colony-stimulating factor (G-CSF) on neutropenia, infection, and cytotoxic chemotherapy administration was studied in a randomized trial in patients receiving intensive weekly chemotherapy for non-Hodgkin's lymphoma (NHL). Eighty patients (aged 16 to 71 years) with high-grade NHL (Kiel) of any stage were randomized to receive VAPEC-B chemotherapy alone (39 patients) or with G-CSF administered as a daily subcutaneous dose of 230 micrograms/m2 (41 patients). Prophylactic ketoconazole and cotrimoxazole were administered to all patients throughout treatment. The protocol specified identical dose modification and antibiotic treatment criteria bor both groups. Neutropenia (absolute neutrophil count [ANC] less than 1.0 x 10(9)/L) occurred in 15 of 41 (37%) of the G-CSF-treated patients and in 33 of 39 (85%) of the controls, giving a relative risk for control patients of 2.31 (95% confidence interval [CI], [1.51, 3.54]; P = .00001). Fever (greater than or equal to 37.5 degrees C) with neutropenia (ANC less than 1.0 x 10(9)/L) occurred in 9 of 41 (22%) of the G-CSF group and in 17 of 39 (44%) of the controls (relative risk for control, 2.26; 95% CI [1.01, 5.06]; P = .04). There were fewer treatment delays, with shorter duration (P = .01) in patients receiving G-CSF. Chemotherapy doses were reduced in 4 of 41 (10%) of the G-CSF patients and 13 of 39 (33%) of the controls (P = .01). The dose intensity of cytotoxic chemotherapy was significantly increased in patients receiving G-CSF (median of 95% in G-CSF group compared with 83% in control patients). Three vascular deaths occurred in the G-CSF group. Delays in the control group most commonly resulted from neutropenia (19 patients, compared with 2 patients in the G-CSF-treated group, P = .000007). Severe mucositis was the major dose-limiting toxicity in G-CSF-treated patients, but did not occur more frequently than in controls (15 patients in each group). Overall, patients randomized to receive G-CSF achieved a greater dose intensity than control patients, but this did not result in significant differences in drug toxicity (other than neutropenia), intravenous antibiotic usage, or hospitalization between the two groups.

Adolescent↗
PubMed1992

Effects of selective opioid receptor agonists and antagonists during myocardial ischaemia.

The antiarrhythmic activities of 16-methylcyprenorphine (M8008), nor-binaltorphimine (NBT) and naltrexone, which are relatively specific opioid receptor antagonists for delta, kappa and mu receptors, respectively, were examined during the 30 min following coronary artery occlusion in anaesthetised rats. The haemodynamic and electrocardiographic effects of the opioid receptor agonists [D-Ala2,D-Leu5]enkephalin (DADLE) (relatively selective for delta receptors), ICI-204448 (kappa) and glyol (mu) were also investigated over the 30-90 min post ligation period. When administered intravenously 5 min before ligation, M8008 (0.5 mg kg-1 and 2.5 mg kg-1) reduced the number of ventricular ectopic beats but had no effect on the incidence or duration of ventricular fibrillation. NBT and naltrexone were not antiarrhythmic at a dose of 0.5 mg kg-1 but at 2.5 mg kg-1 (a concentration at which both drugs block kappa receptors) the number of ventricular ectopic beats, the incidence of ventricular fibrillation and mortality were all reduced. All of the opioid receptor agonists caused a transient decrease in heart rate and in arterial blood pressure but none exhibited an arrhythmogenic effect. These studies suggest that the delta and kappa opioid receptor antagonists used may be antiarrhythmic as a result of blockade of the action of endogenously released peptides acting on these receptors or that they have a non-specific 'direct' antiarrhythmic action.

Animals↗
PubMed1992

The electrophysiological effects of opioid receptor-selective antagonists on sheep Purkinje fibres.

The cardiac electrophysiological effects of 16-methylcyprenorphine (M8008), nor-binaltorphimine (NBT) and naltrexone, which are relatively specific opioid antagonists for delta, kappa and mu receptors, respectively, were studied in paced (1.5 Hz) sheep Purkinje fibres in vitro. M8008 (1 ng ml-1-10 micrograms ml-1) caused a concentration-dependent reduction in the maximum rate of depolarisation of phase 0 (MRD) and in the action potential duration measured at 50% repolarisation, APD50. Neither NBT (10 ng ml-1-10 micrograms ml-1) nor naltrexone (1 ng ml-1-10 micrograms ml-1) produced any significant effect on the cardiac action potential. In the presence of a physiological salt solution modified to mimic some of the changes that occur during myocardial ischaemia (i.e. hypoxia, acidosis, hyperkalaemia), M8008 caused a more marked reduction in MRD and prolonged rather than shortened APD50. These results suggest that the reported antiarrhythmic activity of M8008, but not NBT or naltrexone, may be, at least in part, explained by a direct cardiac electrophysiological action.

Acidosis↗
PubMed1992

Pigeons and peritonitis?

We report an outbreak of fungal peritonitis due to Candida parapsilosis in 12 patients undergoing chronic ambulatory peritoneal dialysis (CAPD). All 12 patients were treated by removal of the CAPD catheter together with systemic antifungal therapy. There were no peritonitis-related deaths. Four patients were successfully returned to CAPD at a later date. Microbiological investigation during the outbreak demonstrated colonization of various areas of the CAPD Unit and medical ward with the organism. C. parapsilosis was also isolated from pigeon guano obtained from window-sills. The number of cases of peritonitis due to this organism decreased markedly after bird-proof netting was installed. We believe that this is the first report of an outbreak of CAPD peritonitis due to faecal carriage of C. parapsilosis by pigeons.

Adult↗
PubMed1991

Non-attendance for appointments in an out-patients' x-ray department.

A total of 5,323 appointments from July 1987 to June 1988 was entered into the study. They showed that for the 12 month period the rate of non-attendance was 5%. The non-attender was most likely to have been referred from a GP for a barium meal and be from the age group 16-25. The district the patient came from had little influence. Non-attendance is not affected by the number of appointments given and if compared to the previous year shows a similar monthly pattern. This pattern does not appear to be influenced by the weather but would seem affected to some extent by holiday periods. Reasons for non-attendance were collected on 51 patients. The main reason given was illness. A large group had had no further contact with the referral source. The cost of staffing for non-attendance was considered to be low when compared to the whole budget. The effect of non-attendance on the waiting list is now minimal. Taking this into account the main recommendations are that: a specified senior member of staff should be responsible for the appointment system and inter-departmental liaison; instruction/appointment confirmation sheets should be reviewed; and the counselling service should be improved. Now the population served has been demographically recorded we can look towards providing for its needs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1976

Deafness in sarcoidosis.

A case of sarcoidosis and sensori-neural deafness in which the lesion was thought to be cochlear in position is presented and the audiometric findings are discussed in detail. A review of the reported cases shows that sarcoid lesions may involve the hearing mechanism at any point along its neural axis.

Adult↗
PubMedDate not supplied

Cystic fibrosis: recent advances in genetics and molecular biology.

Cystic fibrosis (CF) is the most common lethal hereditary disease of Caucasians, occurring once for every 2,000 live births. One out of 20 persons in the United States white population is a heterozygous carrier. An autosomal recessive pattern of inheritance is well established. The disease affects the respiratory and digestive tracts most severely. Despite the clearcut hereditary nature of the disease, insight into the biochemistry of CF has been almost totally lacking until very recently. New evidence strongly indicates that abnormal chloride ion transportation underlies the clinical manifestations. Recent advances in molecular genetics have established that the CF disease gene is located on the long arm of chromosome 7. Several restriction fragment length polymorphisms (RFLP) markers are closely linked to the CF gene. These markers permit antenatal testing of samples from fetuses at risk for CF with a high probability of disease prediction. One laboratory has isolated a desoxyribonucleic acid (DNA) sequence from chromosome 7 which is a candidate for the CF gene itself. A protein called the CF antigen is coded by a gene on chromosome 1. Patients with CF and carriers have abnormally high serum levels of this protein. In the normal state, the product of the CF gene on chromosome 7 may interact with the product of the gene on chromosome 1, enabling its normal catabolism and function. The structure of the CF antigen suggests that it may regulate ion transport.

Alleles↗
PubMedDate not supplied

The killing fields.

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Aged↗