scholarly journals Tamoxifen-associated eye disease. A review.

1996 ◽  
Vol 14 (3) ◽  
pp. 1018-1026 ◽  
Author(s):  
S G Nayfield ◽  
M B Gorin
Keyword(s):  
Breast Cancer ◽  
Adverse Effects ◽  
Macular Edema ◽  
Case Reports ◽  
Eye Disease ◽  
High Dose ◽  
Ocular Toxicity ◽  
Early Stage Disease ◽  
Clinical Series

PURPOSE The oral antiestrogen tamoxifen has demonstrated efficacy in the treatment of metastatic breast cancer and as adjuvant therapy in early-stage disease. Clinical trials of tamoxifen in chemoprevention of breast cancer among high-risk women have focused attention on potential adverse effects of long-term tamoxifen use, including the possibility of ocular toxicity. This review evaluates the published case reports, clinical series, and clinical trial data on ocular toxicities attributed to tamoxifen. Clinical issues of surveillance, differential diagnosis, and management of tamoxifen-related eye disease are discussed. DESIGN National Library of Medicine online bibliographic services were used to identify case reports and clinical studies of ocular adverse effects that occurred in patients receiving tamoxifen published through the fall of 1994. The medical literature relevant to issues raised by the reports and studies was similarly identified and reviewed. RESULTS Case reports and case series identify crystalline retinal deposits, macular edema, and corneal changes as potential tamoxifen ocular toxicities. Extensive retinal lesions and macular edema with visual impairment have been reported in a few patients receiving high-dose tamoxifen. Less extensive retinal changes may occur in patients receiving low doses for long periods, and isolated retinal crystals may be observed in patients without visual symptoms. CONCLUSION Ocular toxicity is uncommon in the current clinical setting of long-term, low-dose tamoxifen use. Physicians should be aware of the potential for ocular toxicity among patients receiving the drug and should assure appropriate surveillance and prompt evaluation of visual complaints.

Incest: What do we Really Know about It?

1987 ◽  
Vol 21 (4) ◽  
pp. 430-440 ◽  
Author(s):  
R. Kosky
Keyword(s):  
Adverse Effects ◽  
Sexual Activity ◽  
Sexual Intercourse ◽  
Current Knowledge ◽  
Epidemiological Studies ◽  
Scientific Basis ◽  
Long Term Effects ◽  
Clinical Series ◽  
General Populations

The literature on incest is reviewed. Current knowledge rests on a very insecure scientific basis and has been mainly derived from small, highly selected clinical series. Recently, some important epidemiological studies of general populations have been reported, but the results of prevalence are inconsistent. Overall, however, it appears that incest, when defined in terms of sexual intercourse, occurs in less than 1% of the population, but other forms of intrafamilial sexual activity may affect 10% of females before they are 16 years of age. Some children are more at risk than others. Because information has generally been derived from court or treatment samples, we are unclear about the long-term effects of incest experiences but, overall, the impression is that incest has markedly adverse effects, especially if it is accompanied by violence and threats and is directed, as it usually is, at the young pre-pubescent child.

scholarly journals Systematic Review of Adverse Effects: A Further Step towards Modernization of Acupuncture in China

2015 ◽  
Vol 2015 ◽  
pp. 1-19 ◽  
Author(s):  
Junyi Wu ◽  
Yanmei Hu ◽  
Yin Zhu ◽  
Ping Yin ◽  
Gerhard Litscher ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Systematic Review ◽  
Central Nervous System ◽  
Adverse Effects ◽  
Scientific Literature ◽  
Acupuncture Treatment ◽  
Case Reports ◽  
The World ◽  
Organ Tissue

As a further step towards the modernization of acupuncture, the objective of this review was to figure out the frequency and severity of adverse complications and events in acupuncture treatment reported from 1980 to 2013 in China. All first-hand case reports of acupuncture-related complications and adverse events that could be identified in the scientific literature were reviewed and classified according to the type of complication and adverse event, circumstance of the event, and long-term patient outcome. The selected case reports were published between 1980 and 2013 in 3 databases. Relevant papers were collected and analyzed by 2 reviewers. Over the 33 years, 182 incidents were identified in 133 relevant papers. Internal organ, tissue, or nerve injury is the main complications of acupuncture especially for pneumothorax and central nervous system injury. Adverse effects also included syncope, infections, hemorrhage, allergy, burn, aphonia, hysteria, cough, thirst, fever, somnolence, and broken needles. Qualifying training of acupuncturists should be systemized and the clinical acupuncture operations should be standardized in order to effectively prevent the occurrence of acupuncture accidents, enhance the influence of acupuncture, and further popularize acupuncture to the rest of the world.

scholarly journals Laporan Kasus: Manifestasi Oral Penderita Hipertensi berupa Ginggival Enlargement

2020 ◽  
Vol 17 (2) ◽  
pp. 54
Author(s):  
Anindita L. ◽  
Aris Aji K. ◽  
Arcadia Sulistijo J.
Keyword(s):  
Case Reports ◽  
Gingival Tissue ◽  
High Dose ◽  
Gingival Inflammation ◽  
Gingival Enlargement ◽  
History Of ◽  
Root Planning ◽  
Pro Inflammatory Cytokines

Hypertension presents an increase in blood pressure following the oral manifestations, such as gingival enlargement. A 42-year-old woman came to the General Sudirman University Dental and Oral Hospital complaining of enlarged front gums seven years ago. The patient had a history of hypertension and regularly consumed drugs, amlodipine 5 mg. Extraoral examination revealed no lymphadenopathy and no swelling of the head and neck area. Intraoral examination revealed a gingival enlargement involving the papilla to the gingival margin present on the entire upper and lower labial gingival surface. The patient's diagnosis was gingival enlargement caused by gingival enlargement due to the use of amlodipine. Gingival enlargement has been noted with long-term or high-dose amlodipine use. The mechanism of amlodipine in causing gingival enlargement is through the role of fibroblasts with abnormal susceptibility to the drug, resulting in increased levels of protein synthesis, especially collagen. The role of pro-inflammatory cytokines occurs through an increase in interleukin-1β (IL-1β) and IL-6 in the inflamed gingival tissue due to the gingival fibrogenic response to drugs. Therapies were DHE and scaling and root planning as phase I in periodontal treatment. Plaque elimination is vital to reduce gingival inflammation that may occur. Substitution of the drug amlodipine may be needed if there is no improvement. Based on case reports, hypertension patients who took amlodipine could have gingival enlargement. The therapy given was plaque elimination in the form of DHE and Scaling and regular check-ups with the dentist.

Radiation-Induced DNA Damage as a Predictor of Long-Term Toxicity in Locally Advanced Breast Cancer Patients Treated with High-Dose Hyperfractionated Radical Radiotherapy

2007 ◽  
Vol 168 (4) ◽  
pp. 415-422 ◽  
Author(s):  
Beatriz Pinar ◽  
Pedro Carlos Lara ◽  
Marta Lloret ◽  
Elisa Bordón ◽  
María Isabel Núñez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Dna Damage ◽  
Cancer Patients ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
High Dose ◽  
Radical Radiotherapy ◽  
Breast Cancer Patients ◽  
Radiation Induced

Abstract 17468: Left Ventricular Remodeling Index (LVRI) in patients after breast cancer therapy in the long-term follow-up

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Felix Heggemann ◽  
Hanna Buggisch ◽  
Grit Welzel ◽  
Christina Doesch ◽  
Jochen Hansmann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Therapy ◽  
Radiation Dose ◽  
Ventricular Remodeling ◽  
Left Ventricular ◽  
High Dose ◽  
Breast Cancer Therapy ◽  
Additional Chemotherapy ◽  
Whole Heart

Introduction: Cardiotoxic side effects are of concern in long-term survivors of left-sided breast cancer therapy. 3-dimensional conventional radiotherapy (3DCRT) deposits high doses in defined regions of the heart. Intensity modulated radiotherapy (IMRT) reduces local high-dose exposition at the expense of exposing more heart tissue to lower doses. Cardio-MRI was performed in this study to assess MRI-morphologic and functional alterations after 3DCRT and IMRT/ additional chemotherapy, with IMRT only performed in patients that would have been exposed to unacceptably high heart doses with 3DCRT. Methods: 49 patients with left-sided breast cancer (38 3DCRT and 11 IMRT; 20 patients with additional adjuvant chemotherapy (ACH) (13 3DCRT, 7 IMRT) were included prospectively. Baseline (pre-treatment) and 24 months post-treatment MRI was performed. With MRI, enddiastolic left ventricular mass (LVM), enddiastolic left ventricular volume (LVEDV) and stroke volume (SV) were assessed. LVRI was calculated with the formula LVM/LVEDV. Results: Mean dose for the whole heart was higher in IMRT than in 3DCRT patients (12.9±3.9 vs. 4.5 ±2.4 Gy). Larger regions received a higher radiation dose (>40Gy) in 3DCRT than in IMRT patients (3.3% vs. 1.3% of the whole heart). High local radiation dose > 50 Gy only occurred in the 3DCRT group (0.74% of the heart volume). After 24 months LVRI decreased significantly in patients with ACH (0.80 vs. 0.70, p=0.028). Non-significant decrease of LVRI was observed in the whole cohort (0.85 vs. 0.79), after IMRT (0.74 vs. 0.71), after 3DCRT (0.88 vs. 0.82) and without ACH (0.87 vs. 0.84). Decrease of LVRI in patients with ACH was caused by significant decrease of LVM (102.4 vs. 89.7 g, p=0.028) whereas LVEDV was stable (128.3 vs. 128.1g). In all groups, no significant decrease of SV could be assessed after 24 months. Conclusions: 24 months after therapy, significant decrease of LVRI due to decreased LVM could be found only in patients with additional chemotherapy. Radiotherapy alone did not have a significant impact on LVRI, LVM and SV. Low doses to the whole heart with IMRT did not cause significant decreases in LVRI, LVM and SV. LVM and LVRI are to be assessed in larger cohorts in patients with cancer therapy especially with additional chemotherapy.

Propofol for the long-term sedation of a critically ill patient

1998 ◽  
Vol 7 (1) ◽  
pp. 73-76 ◽  
Author(s):  
LJ Miller ◽  
R Wiles-Pfeifler
Keyword(s):  
Adverse Effects ◽  
English Language ◽  
Case Reports ◽  
Critically Ill Patient ◽  
Limited Data ◽  
Safety And Efficacy ◽  
Medline Search ◽  
Cardiovascular Depression ◽  
Language Literature

OBJECTIVE: To report a case in which propofol was used successfully in an intubated patient on a prolonged basis and to review the literature that discusses long-term infusions (> 7 days) of propofol. METHODS: Information was retrieved from a MEDLINE search of the English-language literature. Reports of clinical trials and case reports that compared the safety and efficacy of long-term propofol and midazolam were included in this review. Information about the study design and the efficacy and adverse effects of the drugs was collected, and the data were synthesized. RESULTS: Clinical reports indicate that a long-term infusion of propofol is comparable in safety and efficacy to a long-term infusion of midazolam. The distinct adverse-effect profile of long-term use of propofol, including hypertriglyceridemia, was evaluated and reported as significant. CONCLUSION: The limited data available suggest that long-term infusion of propofol is a practical alternative to use of standard agents for sedation of intubated patients. Adverse effects such as cardiovascular depression, respiratory depression, and hypertriglyceridemia may limit the routine use of propofol.

Fluconazole-Induced Symptomatic Phenytoin Toxicity

1994 ◽  
Vol 28 (2) ◽  
pp. 191-195 ◽  
Author(s):  
Richard M. Cadle ◽  
Golden J. Zenon ◽  
Maria C. Rodriguez-Barradas ◽  
Richard J. Hamill
Keyword(s):  
Continuous Monitoring ◽  
Case Reports ◽  
Review Literature ◽  
High Dose ◽  
Data Synthesis ◽  
High Doses ◽  
Phenytoin Toxicity ◽  
Cytochrome P 450 ◽  
Hepatic Cytochrome

OBJECTIVE: To report two cases of fluconazole-induced symptomatic phenytoin toxicity and review literature related to this interaction. DATA SOURCES: Case reports and review articles identified by a computerized (MEDLINE) and manual ( Index Medicus) search. DATA SYNTHESIS: Fluconazole is a broad-spectrum triazole antifungal agent primarily eliminated by renal mechanisms, although hepatic cytochrome P-450 inhibition and hepatotoxicity have been observed. We report two cases of fluconazole-induced symptomatic phenytoin toxicity. Both patients received high doses of the drug; one patient developed phenytoin toxicity only after long-term coadministration. Previously reported cases have occurred primarily with high-dose fluconazole and short-term coadministration. CONCLUSIONS: Fluconazole can increase phenytoin serum concentrations leading to toxicity. Constant and continuous monitoring of serum phenytoin concentrations with fluconazole doses as low as 200 mg/d is warranted.

Impact of selection process on response rate and long-term survival of potential high-dose chemotherapy candidates treated with standard-dose doxorubicin-containing chemotherapy in patients with metastatic breast cancer.

1997 ◽  
Vol 15 (10) ◽  
pp. 3171-3177 ◽  
Author(s):  
Z U Rahman ◽  
D K Frye ◽  
A U Buzdar ◽  
T L Smith ◽  
L Asmar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Response Rate ◽  
Standard Dose ◽  
Metastatic Breast ◽  
High Dose Chemotherapy ◽  
Long Term Results ◽  
High Dose ◽  
Term Survival

PURPOSE Most of the data about high-dose chemotherapy (HDCT) for metastatic breast cancer are derived from phase II studies. The interpretation of these data depends on comparisons with data from properly selected historical control patients treated with standard therapy under similar circumstances. We report the long-term results of patients with metastatic breast cancer who were eligible for HDCT but were treated with doxorubicin-containing standard-dose chemotherapy. PATIENTS AND METHODS Prospectively collected data from 18 successive doxorubicin-containing protocols for the treatment of metastatic breast cancer were evaluated. Using common eligibility criteria for HDCT, we identified patients who would have been candidates for HDCT. We analyzed response rates, progression-free survival (PFS), and overall survival (OS) for all patients, potential HDCT candidates, and noncandidates. RESULTS A total of 1,581 patients was enrolled onto the 18 studies. Six hundred forty-five were HDCT candidates, and 936 were noncandidates. The complete response rate was 27% for HDCT candidates and 7% for noncandidates; median PFS was 16 and 8 months and median OS was 30 and 17 months, respectively. Survival rates for HDCT candidates and noncandidates, respectively, were 21% and 6% at 5 years and 7% and 2% at 10 years. CONCLUSION This study suggests that encouraging results of single-arm trials of HDCT could partially be due to selection of patients with better prognoses and further stresses the importance of completing ongoing randomized trials of HDCT to assess the relative efficacy of HDCT in patients with metastatic breast cancer.

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