RESUMEN
PURPOSE: To evaluate the influence of a H2 receptor antagonist (cimetidine) on survival in patients with colorectal carcinoma, a randomized, controlled pilot study was performed in three university hospitals in Copenhagen, Denmark. METHODS: A total of 192 patients, who had undergone a resection or an exploratory operation for adenocarcinoma of the colon or rectum between May 1988 and May 1991, were enrolled in the study. After a median observation time of 40 months, outcome was noted for each patient concerning cancer-specific mortality rate. RESULTS: In patients operated with curative intent (n = 148), no difference was found in cancer-specific mortality between the two treatments. However, a tendency toward reduction in mortality rate was found in patients with curatively operated Dukes Stage C carcinoma (P = 0.11, log-rank test; difference, 29 percent; 90 percent confidence interval, 2 to 57 percent) in the cimetidine-treated group. In patients with disseminated disease no total difference was found between the two treatment groups. CONCLUSIONS: Cimetidine does not seem to reduce mortality in patients with colorectal cancer, but there seems to be a tendency toward a survival benefit in patients undergoing surgery for Dukes Stage C carcinoma. Results seem to justify trials in this patient category to reveal a benefit of H2 receptor antagonists in adjuvant therapy of colorectal carcinoma.
Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Cimetidina/uso terapéutico , Neoplasias del Colon/tratamiento farmacológico , Neoplasias del Recto/tratamiento farmacológico , Adenocarcinoma/mortalidad , Adenocarcinoma/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Quimioterapia Adyuvante , Neoplasias del Colon/mortalidad , Neoplasias del Colon/cirugía , Dinamarca/epidemiología , Método Doble Ciego , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Placebos , Neoplasias del Recto/mortalidad , Neoplasias del Recto/cirugía , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
Fifteen patients who developed a persistent perineal sinus after excision of the rectum and eight patients with a perineal fistula appearing after treatment of perineal abscesses were treated with instillation of fibrin adhesive to close the sinus or fistula. In 12 patients, the sinus tracts or fistulas were completely and permanently closed (52 percent). In five patients (22 percent), the fistulas healed after two or three attempts, while, in six patients (26 percent), the method failed to provide lasting closure. The method seems to be a valuable alternative in the treatment of a persistent, long and narrow perineal sinus or fistula.
Asunto(s)
Cefotaxima/uso terapéutico , Adhesivo de Tejido de Fibrina/uso terapéutico , Fístula/tratamiento farmacológico , Metronidazol/uso terapéutico , Perineo , Complicaciones Posoperatorias/tratamiento farmacológico , Recto/cirugía , Administración Tópica , Adulto , Anciano , Cefotaxima/administración & dosificación , Quimioterapia Combinada , Femenino , Adhesivo de Tejido de Fibrina/administración & dosificación , Fístula/etiología , Estudios de Seguimiento , Humanos , Masculino , Metronidazol/administración & dosificación , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Recurrencia , Irrigación TerapéuticaRESUMEN
Six patients with advanced disseminated cancer were treated by operatively implanting a subcutaneous injection system for epidural opiate injection. The system consisted of an access port connected to an epidural catheter. The median period of treatment during hospitalization was 16 days (9-64). Two discharged patients were treated for 9 and 150 days, respectively. The median number of injections was 92 (48-542). Patient compliance was good in all cases. There was no case of displacement, kinking or occlusion of the catheters. All patients experienced sufficient pain relief, although four, before epidural opiate treatment, had their pain triggered by activity.
Asunto(s)
Inyecciones Epidurales/instrumentación , Narcóticos/administración & dosificación , Neoplasias/fisiopatología , Dolor Intratable/tratamiento farmacológico , Humanos , Inyecciones Epidurales/métodosRESUMEN
The relationship between diabetes mellitus and the exocrine pancreatic function was evaluated in 29 patients with insulin-dependent diabetes mellitus by measuring cathodic trypsin-like immunoreactivity (TLI) and the enzymatic activity of pancreatic isoamylase in serum before and 90 min after breakfast and insulin. Thirty healthy subjects served as reference group. Median fasting serum concentrations in the diabetic subjects were significantly lower than in the reference subjects: for TLI 143 and 299 micrograms trypsin standard/l and for pancreatic isoamylase 43 and 101 U/l, respectively (p less than 0.001 for both). A positive correlation between TLI and pancreatic isoamylase was present in the diabetics (Sperman's rho = 0.56, p less than 0.01). The serum concentrations of TLI and pancreatic isoamylase were not related to the duration of diabetes, daily insulin dose or glycemic control measured by blood glucose and total glycosylated hemoglobins. Cathodic TLI and pancreatic isoamylase in serum were not influenced by food and insulin.