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K Sombolos

Publications and source records attributed to K Sombolos.

29 records · Page 2Linked to original sources
PubMed1991

Platinum-based chemotherapy followed by radiation therapy of locally advanced nasopharyngeal cancer. A retrospective analysis of 39 cases.

A retrospective analysis was performed of 39 patients with locally advanced nasopharyngeal cancer treated with combined chemotherapy and radiation therapy during the last five years at our departments. There were 26 men and 13 women with median age 55 (24-75) years. Histology was squamous cell carcinoma in 6 patients and undifferentiated carcinoma in the remaining 33 patients. Induction chemotherapy consisted of either regimen A (cisplatin 100 mg/m2 day 1, 5-FU 1,000 mg/m2 days 2-6 as continuous infusion, bleomycin 15 mg days 15 and 29 i.m., mitomycin 4 mg/m2 day 22 and hydroxyurea 1,000 mg/m2 daily days 23-27) or regimen B (carboplatin 300 mg/m2 day 1, 5-FU 1,000 mg/m2 days 1-5 as continuous infusion and methotrexate 1.2 g/m2 day 14 with leucovorin rescue). After completion of induction chemotherapy 13 patients (33%) had complete remission (CR) and 19 (49%) partial remission (PR). The CR rate was increased after radiation therapy to 72%. Survival rates were 88% at 12 and 78% at 24 months. Median time to progression was 29.5 months. In conclusion, induction chemotherapy with a platinum-based regimen followed by radiation therapy achieved a high rate of local control. If the treatment also prolongs survival must, however, be studied by randomized trials.

Adenocarcinoma↗
PubMed1991

Effect on atrial natriuretic peptide by bracing in scoliosis. Boston brace removal studied in 10 cases.

The immediate effect of Boston brace removal on plasma levels of atrial natriuretic peptide and arginine vasopressin was studied in 10 patients with idiopathic scoliosis ranging in age from 12 to 16 years. Blood samples were drawn via the antecubital vein in the supine position with the brace on and 10 min after brace removal. ANP and AVP plasma levels were measured by radioimmunoassay. Although no differences were found in the plasma concentrations of arginine vasopressin while on and after removal of the brace, atrial natriuretic peptide levels showed an approximately 80 percent increase 10 min after brace removal, presumably due to central volume redistribution. The changes of atrial natriuretic peptide plasma levels observed may be related to previously reported changes of the glomerular filtration rate and urinary sodium excretion following brace removal.

Adolescent↗
PubMed1990

Induction chemotherapy with a new regimen alternating cisplatin, fluorouracil with mitomycin, hydroxyurea and bleomycin in carcinomas of nasopharynx or other sites of the head and neck region.

Sixty-six patients with locally advanced (Stages III and IV) carcinoma of the head and neck were treated with three cycles of induction chemotherapy, consisting of cisplatin, fluorouracil (FU) infusion, bleomycin, mitomycin, and hydroxyurea, followed by radiotherapy and/or surgery. There were 48 men and 18 women with a median age of 55 years (range, 18 to 75 years) and Karnofsky performance status of 80 (range, 40 to 90). Primary site was nasopharynx (28 patients), followed by larynx (12) and others (26). Forty-one (62%) patients were presented with Stage IV disease. The response rate to induction chemotherapy was 27% complete response, 50% partial response, 20% stable disease, and 3% progressive disease. There was no significant difference in response rate between patients with cancer of nasopharynx or other sites (P greater than 0.1). Survival was 61% at 24 months. Patients with cancer of nasopharynx had a better survival than those with other primaries (P = 0.033). Toxicities from chemotherapy included alopecia (73%), nausea/vomiting (66%), leukopenia (54%), stomatitis (36%), anemia (32%), thrombocytopenia (16%), and diarrhea (9%). Grade IV toxicity was not observed. Induction chemotherapy with this new regimen resulted in a high response rate but may not be superior to cisplatin and FU alone. It can be safely combined with radiotherapy as a potentially curative therapy in squamous cell carcinoma of the head and neck. Chemotherapy followed by radiation therapy may yield survival similar to radical surgery in laryngeal and other head and neck cancers.

Adult↗
PubMed1990

Peritonitis-related deaths in continuous ambulatory peritoneal dialysis (CAPD) patients.

A total of 636 episodes of peritonitis occurred in 440 patients who entered our continuous ambulatory peritoneal dialysis (CAPD) program from September 1977 to February 1988. Sixteen patients (8 male and 8 female, aged 37-77 years) died during an episode of peritonitis (fatality rate 2.5%). They had been on CAPD for 3 to 105 (average 39) months. Six of them were diabetics. The peritonitis rate among these 16 patients were 1 episode per 12 patient months, while the corresponding figure for the whole (440) CAPD population was 14 patient months. Risk factors present in the 16 patients were: cardiovascular disease (12), cerebrovascular accident (2) peripheral artery disease (1) and pulmonary fibrosis (1). Fever and leukocytosis were present on admission in 11 patients, while total serum proteins and albumin were significantly lower (p less than 0.001) than the corresponding values before peritonitis (56 +/- 8 vs. 65 +/- 5). Staph. aureus was isolated in 8 patients (50%), multiple organisms in 6, Pseudomonas and Candida albicans in 1 each. An abdominal abscess was found in 4 (25%) patients. The peritoneal catheter was removed between the 5th and 10th day in 6 and after the 10th day in 7 patients. Peritonitis with sepsis was the cause of death in 13 patients. Contributing factors were cardiovascular accident in 9, uremic coma in 2, extensive GI bleeding in 2, GI perforation in 2, intestinal infarction in 1, and pneumonia in 2 patients. We conclude that the risk of peritonitis-related death in CAPD patients is increased with Staph. aureus or multibacterial peritonitis. Contributing factors are concomitant cardiovascular disease and delayed (greater than 5 days) catheter removal.

Cardiovascular Diseases↗
PubMed1990

Six-month overnight intraperitoneal amino-acid infusion in continuous ambulatory peritoneal dialysis (CAPD) patients--no effect on nutritional status.

The long-term effect of an AA solution based on Travasol, a solution for total parenteral nutrition, given intraperitoneally over a 6-month period was studied in 5 patients 22 to 75 years old, having been on continuous ambulatory peritoneal dialysis (CAPD) for 3 to 57 months. A low oral protein intake (less than 0.8 g/kg bw/day) and/or a low serum albumin (less than 35 g/L) were used as inclusion criteria. Two liters of 1% AA solution were infused overnight, while a glucose Dianeal was used for the other exchanges. During the study, BUN increased from 22.04 mM/L to 28.06 mM/L the first month and remained at these levels, indicating the increased protein intake. However, average oral total energy and protein intake, body weight (bw), serum creatinine, cholesterol, triglycerides, total proteins, albumin, transferrin, skinfold thickness, total body potassium, and plasma AA levels remained basically unchanged. The average total body nitrogen decreased from 1.746 to 1.554 Kg, but this decrease did not reach statistical significance (p greater than 0.05). We conclude that intraperitoneal overnight administration of 2 L of 1% AA based on Travasol over 6 months did not improve the nutritional status of CAPD patients. This ineffectiveness might be due to the AA composition of the solution, the timing of administration, or to a low caloric intake and/or that our patients were not severely malnourished.

Amino Acids↗
PubMed1989

Changes in peritoneal membrane transport rates in patients on long term CAPD.

Peritoneal equilibration tests (PET's) are a simple means of monitoring peritoneal membrane function in C.A.P.D. patients. Findings on initial testing have been proposed as having prognostic value for a patient's course on peritoneal dialysis. 177 serial P.E.T.'s were performed in 49 patients at six monthly intervals using a 2 litre 4.25% dextrose exchange and a four hour dwell and equilibration ratios were calculated for urea (D/P U), creatinine (D/P C) and glucose (D/Do G). Alterations in equilibration ratios with time were not significant in the group as a whole. However, a subgroup of 12 patients was identified in whom there were significant increases in D/P U (p .02) and in D/P C (p .003) and decreases in D/Do G (p .025) between zero and 18 months. A subgroup of five patients in whom D/P U decreased significantly (p .05) was also identified. These subgroups did not differ significantly in clinical characteristics although peritonitis was more frequent in the group with increasing transport. As results of P.E.T.'s alter with time in many patients prognostication based on initial values only may not be valid.

Adolescent↗
PubMed1987

Acquired cystic disease of the kidney in association with chronic ambulatory peritoneal dialysis.

A combined necropsy and ultrasound study in patients with end-stage renal disease treated exclusively by peritoneal dialysis revealed acquired cystic disease of the kidney (ACDK) in five of 15 necropsies and in one of seven sonograms from living patients. Two benign microscopic adenomas were also found in the first group of patients. No malignant renal tumors or hemorrhagic complications were detected. The cause of the cyst formation is clearly related to chronic renal failure rather than dialysis per se, as one patient had cysts prior to CAPD and seven of 41 patients with end-stage renal disease in the predialysis era were found to have renal cysts on postmortem examination. This study shows that ACDK is not uncommon in patients with chronic renal failure treated by chronic ambulatory peritoneal dialysis.

Adenoma↗
PubMed1986

Propionibacteria isolates and asymptomatic infections of the peritoneal effluent in CAPD patients.

During the past two years our laboratory has isolated Propionibacterium-an anaerobic Gram-positive rod-on 40 occasions from the drainage fluid of 25 patients on CAPD and eight on IPD. Most patients had no symptoms and the fluid was sent for culture after treatment of peritonitis, during training period, and occasionally because it was cloudy. No association was found with patients' age, length on dialysis, or previous peritonitis episodes. The only statistically significant association (P = 0.033) was with recent (less than 30 days) catheter insertion. Patients with Propionibacterium as the only organism in their dialysis fluid had normal leucocyte count in the effluent, minimal or no symptoms, and received no treatment. In order to establish the frequency of positive cultures of asymptomatic patients, we cultured 95 dialysate effluents from 33 asymptomatic CAPD patients. Cultures were observed for 4 weeks. We found seven positive fluids (7.4%) in four patients (12%), aerobic sporeformer (2), Staphylococcus epidermidis (2) and Streptococcus viridans (1). The mean time to grow was 18.6 days. In conclusion, effluents from asymptomatic CAPD patients may contain bacteria. The organisms are commensals requiring prolonged incubation to grow. Propionibacterium isolated from peritoneal effluent of patients with minimal or no symptoms does not require treatment. These findings suggest that errors in the technique of CAPD are not rare but when the number of organisms is small and the organism has low virulence, peritonitis does not occur.

Adult↗