scholarly journals Cardiac failure in patients treated with azacitidine, a pyrimidine analogue: Case reports and disproportionality analyses in Vigibase

2020 ◽  
Vol 86 (5) ◽  
pp. 991-998 ◽  
Author(s):  
Justine Perino ◽  
Nathan Mottal ◽  
Yohann Bohbot ◽  
Vincent Servant ◽  
Aude Berroneau ◽  
...  
Keyword(s):  
Cardiac Failure ◽  
Case Reports ◽  
Pyrimidine Analogue

scholarly journals Gemcitabine-Induced Cardiotoxicity in Patients Receiving Adjuvant Chemotherapy for Pancreatic Cancer: A Case Series

2018 ◽  
Vol 11 (1) ◽  
pp. 221-227 ◽  
Author(s):  
Salma Alam ◽  
Chidi Illo ◽  
Yuk Ting Ma ◽  
Pankaj Punia
Keyword(s):  
Pancreatic Cancer ◽  
Adjuvant Chemotherapy ◽  
Cardiac Failure ◽  
Case Reports ◽  
Case Series ◽  
Standard Of Care ◽  
Cardiac Side Effects ◽  
Early Withdrawal ◽  
Pancreatic Cancers ◽  
Patients With Diabetes

Gemcitabine is not considered a cardiotoxic agent generally; so far only very few case reports have been reported in the literature on different aspects of cardiac side effects. Here we report a case series of 3 patients who developed congestive cardiac failure, when treated with gemcitabine monotherapy in the adjuvant setting for pancreatic cancers. Adjuvant chemotherapy with gemcitabine has been the standard of care for pancreatic cancer patients after successful surgery since the results of the CONKO-001 and ESPAC3 study were published. Gemcitabine was administered on days 1, 8, and 15 of a 28-day cycle at 1,000 mg/m2. All 3 patients developed symptoms suggestive of cardiac failure with a drop in ejection fraction on echocardiography, and responded to conservative treatment for heart failure after withdrawal of gemcitabine therapy. Early withdrawal of gemcitabine chemotherapy is recommended in addition to a need for studies required to evaluate the mechanism of cardiotoxicity. As per available literature, patients with diabetes and having received a total dose greater than 15,000 mg/m2 are generally at a higher risk and require close surveillance.

Lenalidomide (LEN) in INT 2 and High Risk MDS with DEL 5q. Interim Results of a Phase II Trial by the GFM.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 820-820 ◽  
Author(s):  
S. Burcheri ◽  
T. Prebet ◽  
O. Beyne-Rauzy ◽  
R.M. Mbida ◽  
N. Hoarau ◽  
...  
Keyword(s):  
High Risk ◽  
Cardiac Failure ◽  
Case Reports ◽  
Single Agent ◽  
Early Death ◽  
Cytogenetic Response ◽  
Median Number ◽  
Hematological Toxicity ◽  
Almost All ◽  
Dose Reductions

Abstract Background: LEN is now considered a reference (and possibly “targeted “) treatment in IPSS low and int 1 risk MDS with del 5q. Int 2 and high risk MDS with del 5q (with excess of blasts and /or additional cytogenetic abn,) has poor prognosis with limited therapeutic options. Apart from small n° of case reports, results of LEN in those pts are unknown. Methods: We performed a phase I-II study of LEN (10 mg /d x21d q 28 d, increased to 15mg/d after 2 cycles, in the absence of response and DLT) in MDS with del 5q and high or int 2 IPSS (including RAEB-T) . Dose reductions were made in case of NCI CTCAE grade >2 toxicity or, for hematological toxicity, grade 4 (ANC<0.5 G/l or plts <25 G/l). Addition of G-CSF was recommended if ANC< 1 G/l before and during treatment. Response (IWG 2006 criteria) was evaluated after 2 and 4 cycles Results: Between Nov 2006 and July 2007, 49 pts from 9 centres were included. 30 of them, included > 8 weeks before first interim analysis (1 July 2007), are analyzed here: 15 F, 15 M, median age 68 (range 35–85). 4 pts had received previous chemotherapy (2 LD AraC, 2 anthr-AraC). 2 pts had RA, 6 RAEB-1, 12 RAEB-2, 10 RAEB-T. 19 pts were IPSS high and 11 were int 2. Del 5q was isolated, with 1 additional and > 1 additional abn in 4, 8 and 18 pts respectively (resp) (in the last group, median n° of additional abn was 5, range 2–22). All pts had transfusion dependent anemia. Plts were < 100G/l in 16 pts (5 required plt transfusions) and ANC <1.5G/l in 28 pts. Median number of days of LEN received was 34 (range 14–126) . Dose reduction to 5 mg/d or 5mg / 2d was required in 11 pts and 1 pt resp, due to thrombocytopenia (n=9) neutropenia (n=2), rash (n=1). 1 pt stopped LEN after 2 weeks, for unrelated disorder without evidence of progression, and was excluded from analysis. 6 of the 29 evaluable pts (21%), had response (2 CR, 2 PR, 2 HI-E.) 3 (10%) pts died during the first course, from sepsis (2), cardiac failure (1) and the remaining 20 pts progressed within the 2 first cycles All responses were observed after 2 cycles. 2 and 3 of the responders achieved complete and partial cytogenetic response, resp. Duration of CR, PR, and HI-E was 5+ and 4 mos, 5+ and 4+ mos, 2+ and 2 mos, resp. CR or PR was achieved in 4 / 12 pts (33%) with isolated del 5q or with single additional abn vs 0/17 pts with >1 additional abn ; 3/19 pts (16%) with <20% blasts vs 1/10 with >20% blasts; and 4/14 (29%) with initial plts> 100G/l, vs 0/15 pts with lower plts. 18 pts were alive and 11pts had died after 6 to 210 days (median 80) from early death (n= 3, as seen above) or progression (n=8). Non fatal SAEs were sepsis (10), cardiac failure (2), CNS bleeding (1) thrombosis (1 ischemic colitis, 1 pulmonary embolism). Hospitalization was required in 28/29 pts during treatment. Median number of RBC and Plt transfusions during each cycle was 4 and 1.5 resp. 4 pts (all responding) remained on study. Conclusion LEN as single agent, at the dose used, yielded significant responses in high and int 2 MDS with del 5q in the absence of cytogenetic complexity and of thrombocytopenia, while other patients generally progressed rapidly. Significant myelosuppression, requiring hospitalisation in almost all cases, was observed. Higher LEN doses, and/or combination to cytoreductive or hypomethylating agents, may improve results.

scholarly journals Clinical outcome of transfemoral embolisation in patients with arteriovenous malformations of the liver in hereditary haemorrhagic telangiectasia (Weber-Rendu-Osler disease)

Gut ◽  
1998 ◽  
Vol 42 (1) ◽  
pp. 123-126 ◽  
Author(s):  
M Caselitz ◽  
S Wagner ◽  
A Chavan ◽  
M Gebel ◽  
J S Bleck ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Cardiac Failure ◽  
Arteriovenous Malformations ◽  
Clinical Symptoms ◽  
Vascular Malformations ◽  
Case Reports ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Beneficial Effects ◽  
Hepatic Involvement ◽  
Arterial Embolisation

Background—Arteriovenous malformations of the liver in Osler’s disease may present as high output cardiac failure. A few case reports suggested that treatment with arterial embolisation may have beneficial effects in such patients.Aims—To investigate the efficacy and safety of this treatment modality in a prospective pilot study.Patients and methods—Four women and one man (aged 39–59 years) with the dominant hepatic manifestation of Osler’s disease presented with symptoms of cardiac failure and elevated cardiac output. Arteriovenous malformations were treated in three to five sessions with arterial embolisation using coils. The outcome was analysed by measurement of cardiac output and scoring of clinical symptoms.Results—Embolisation was technically feasible in all patients and adequate occlusion of vascular malformations was achieved in four patients. After completion of therapy symptoms improved in four patients, while one patient suffered from abdominal pain due to cholangitis. One patient died seven months after the embolisation treatment from variceal bleeding. Mean cardiac output significantly decreased from 14.2 (range 12–17.3) l/min to 8 (range 5.9–10.6) l/min (p=0.043). After a median follow up of 23 months (range 7–50 months), three of five patients had a long lasting improvement of clinical symptoms and cardiac function.Conclusions—This first treatment series of patients with dominant hepatic involvement in Osler’s disease indicates that arterial embolisation may prevent cardiac failure by significantly lowering cardiac output.

A case of bilateral recurrent exudative pleural effusion in a post COVID patient

2021 ◽  
Vol 32 (2) ◽  
pp. 149-155
Author(s):  
SM AA Mamun ◽  
S Sarker
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Cardiac Failure ◽  
Case Reports ◽  
Bilateral Pleural Effusion ◽  
Pleural Effusions ◽  
Moderate Growth ◽  
Common Causes ◽  
Culture Sensitivity ◽  
Immunological Diseases

COVID-19-related pleural effusions are frequently described during the ongoing pandemic. Pleural effusions result from the accumulation of fluid in the pleural space surrounding the lungs. The most common causes of bilateral pleural effusions are due to congestive cardiac failure, nephrotic syndrome, anasarca due to any protein deficiency state or fluid overload, hypothyroidism. Few exudative causes of bilateral pleural effusion also like tuberculosis, primary and metastatic pleural malignancy, bronchogenic Ca, lymphomas, Immunological diseases: Mixed connective tissue disease, long standing cardiac failure or liver failure (on diuretics). Exudative causes of bilateral turbid pleural effusion with recurrent accumulation are very rare without any other associated pathology. The significance of pleural effusions in COVID-19 pneumonia has not been well assessed due to the rarity of the disease limited to case reports/series. A 72-year-old male patient comes to emergency with the complaints increasing shortness of breath for 3 days, Dry cough for same duration, H/O of COVID pneumonia 2 months back with no other comorbidity. A chest computer tomography (CT) radiograph revealed a bilateral pleural effusion, which was further assessed as exudative type. Pleural fluid study reveals exudative hemorrhagic turbid fluid with ADA 71.5 U/L with neutrophilicleukocytosis. Pleural fluid culture reveals moderate growth of pseudomonas species with scanty growth of Candida species. The patient was diagnosed as a case of bilateral complicated recurrent parapneumonic effusion and treated with antibiotic as culture sensitivity with steroids. After 4 times aspiration paracentesis patient was discharged with minimal bilateral pleural effusion. The patient has been followed for 4 months and now he is doing well. Bangladesh J Medicine July 2021; 32(2) : 149-155

Case Reports Link ADHD Stimulants to Skin Eruptions

2011 ◽  
Vol 45 (12) ◽  
pp. 10
Author(s):  
SHERRY BOSCHERT
Keyword(s):  
Case Reports

Bowel ischaemia after endovascular aneurysm repair

VASA ◽  
2018 ◽  
Vol 47 (4) ◽  
pp. 273-277
Author(s):  
Christopher Lowe ◽  
Oussama El Bakbachi ◽  
Damian Kelleher ◽  
Imran Asghar ◽  
Francesco Torella ◽  
...  
Keyword(s):  
Case Reports ◽  
Endovascular Aneurysm Repair ◽  
Artery Occlusion ◽  
Bibliographic Databases ◽  
Bowel Ischaemia ◽  
Prophylactic Measures ◽  
Increased Risk ◽  
Prisma Statement ◽  
Meta Analyses ◽  
Aneurysm Repair

Abstract. The aim of this review was to investigate presentation, aetiology, management, and outcomes of bowel ischaemia following EVAR. We present a case report and searched electronic bibliographic databases to identify published reports of bowel ischaemia following elective infra-renal EVAR not involving hypogastric artery coverage or iliac branch devices. We conducted our review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. In total, five cohort studies and three case reports were included. These studies detailed some 6,184 infra-renal elective EVARs, without procedure-related occlusion of the hypogastric arteries, performed between 1996 and 2014. Bowel ischaemia in this setting is uncommon with an incidence ranging from 0.5 to 2.8 % and includes a spectrum of severity from mucosal to transmural ischaemia. Due to varying reporting standards, an overall proportion of patients requiring bowel resection could not be ascertained. In the larger series, mortality ranged from 35 to 80 %. Atheroembolization, hypotension, and inferior mesenteric artery occlusion were reported as potential causative factors. Elderly patients and those undergoing prolonged procedures appear at higher risk. Bowel ischaemia is a rare but potentially devastating complication following elective infra-renal EVAR and can occur in the setting of patent mesenteric vessels and hypogastric arteries. Mortality ranges from 35 to 80 %. Further research is required to identify risk factors and establish prophylactic measures in patients that have an increased risk of developing bowel ischaemia after standard infra-renal EVAR.

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