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  • 1
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Busulphan levels in plasma were measured in 27 patients during conditioning therapy (1 mg/kg×4 for 4 days) before bone marrow transplantation. The mean minimal concentration found in children aged 〈5 years (237 ng ml−1) was lower than that observed in adults or older children (607 and 573 ng ml−1, respectively). The AUC for the last dose was significantly lower in young children (2,315 h ng ml−1) than in adults or older children (6,134 and 5,937 h ng ml−1, respectively). The elimination half-life for the last dose in young children was shorter (2.05 h) than that in either adults (2.59 h) or older children (2.79 h). When the AUC was normalized for body surface area, the difference between young children and the other groups was smaller but remained statistically significant. The total body clearance was significantly higher in young children (7.3 ml min−1 kg−1) as compared with both older children and adults (3.02 and 2.7 ml min−1 kg−1, respectively). The plasma levels of busulphan showed circadian rhythmicity, especially in young children. The concentration measured during the night in some patients was up to 3-fold that observed during daytime. We conclude that the busulphan dosage for children must be reconsidered and that further studies are urgently needed to develop an optimal therapy.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An einer schwedischen Universitätsklinik wurde ein Jahr lang eine prospektive Studie über Bakteriämie durchgeführt. Bei 3,6% aller eingewiesenen Patienten wurden Blutkulturen angelegt. Bei 142 Patienten (davon 59% Männer) fanden sich 148 Ereignisse mit Bakteriämie. Die mittlere Bakteriämie-Inzidenz betrug 4,3 Episoden auf 1000 Einweisungen. Bei 1,3% der positiven Blutkulturen lag eine Kontamination vor. Die häufigsten Diagnosen waren Malignome und Harnwegserkrankungen, die häufigsten prädisponierenden Faktoren chirurgische Eingriffe, Zentralvenenkatheter und Zytostatikatherapie. Im Krankenhaus und außerhalb des Krankenhauses erworbene Bakteriämien verhielten sich wie 1,3 : 1; die Letalität betrug 12,7%. Als häufigste pathogene Erreger fanden sich gramnegative Stäbchen aus der Familie derEnterobacteriaceae, als nächst-häufigsteStaphylococcus aureus undStaphylococcus epidermidis. Die verantwortlichen Erreger wiesen ein recht günstiges Empfindlichkeitsspektrum auf. Von denS. aureus-Stämmen war keiner resistent gegen Isoxazolyl-Penicilline oder Gentamicin. Nur einEscherichia coli-Stamm war gegen Gentamicin resistent, aber keiner der Klebsiella-Stämme. Die Ergebnisse wurden mit einer fünf Jahre früher durchgeführten, retrospektiven Studie über ein Jahr verglichen: Die Bakteriämie-Inzidenz hatte sich in der Zwischenzeit nicht geändert.
    Notes: Summary A one-year prospective study of bacteremia was carried out at a Swedish university hospital. Blood cultures were taken in 6.3% of all patients admitted to the hospital. 148 episodes of bacteremia were recorded in 142 patients, 59% of whom were males. The mean incidence of bacteremia was 4.3 episodes per 1,000 admissions. The incidence of contamination was 1.3%. Malignancy and urinary tract disorders were the most common diagnoses and surgical intervention, central venous catheters and cytostatic drugs the most common predisposing factors. The ratio of hospital to community-acquired bacteremia was 1.3:1. The fatality rate was 12.7%. Gram-negative rods belonging to theEnterobacteriaceae were the most common pathogens, followed byStaphylococcus aureus andStaphylococcus epidermidis. The antibiotic sensitivity pattern of the causative bacteria was quite favorable. NoS. aureus strains were resistant to isoxazolyl penicillins or gentamicin. No Klebsiella strain and only oneEscherichia coli strain was resistant to gentamicin. The results were compared to a one-year retrospective study carried out in the same hospital five years ago. The incidence of bacteremia had not increased between the two studies.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-7339
    Keywords: Key words Bacteremias ; Central venous catheters ; Prevention ; Teicoplanin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A prospective, randomized, open study comparing two doses of teicoplanin with no therapy administered at the time of insertion of a central venous catheter was performed in patients with hematological malignancies and in patients scheduled to undergo allogeneic or autologous stem cell transplantation. The study was designed as a group sequential study. At predetermined intervals statistical analysis was performed for the main efficacy variable, which was the number of days to treatment failure. Sixty-five patients were randomized. Three patients were judged to be not evaluable. Baseline characteristics were identical in the two groups. No differences were found in overall infections, bacteremias, gram-positive infections, or local infections between the teicoplanin and control groups. Teicoplanin given at the time of insertion of central venous catheters did not reduce the risk of bacteremias or other line-associated infections.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Supportive care in cancer 6 (1998), S. 469-472 
    ISSN: 1433-7339
    Keywords: Key words Hematological malignancy ; Tetanus immunity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to investigate long-term immunity to tetanus toxoid among patients with hematological disease who had been treated with conventional doses of chemotherapy. Altogether 206 patients with different hematological malignancies were included in the study. There were marked differences between the rates of seronegativity against tetanus, varying from 20% to 70% in different groups of study patients. We found that 21 of 80 (36%) patients with AML, 45 of 80 (56%) with ALL, 12 of 22 (54%) with lymphoma, 4 of 13 (31%) with myeloma and 2 of 11(18%) with CML were not immune to tetanus. In a multivariate logistic regression model increasing age (P=0.0001), lymphoid malignancy (P=0.0005) and advanced disease stage (P=0.0001) were independent risk factors for loss of tetanus immunity in patients with hematological malignancies.
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  • 5
    ISSN: 1433-7339
    Keywords: Key words Autologous transplantation ; Bone marrow ; Peripheral stem cells ; Infectious complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Patients who receive transplants of autologous peripheral stem cells have a shorter duration of neutropenia than patients who receive autologous bone marrow transplants. There is conflicting evidence regarding the risk of infections. A retrospective analysis on 123 patients who received transplants of either auto- logous bone marrow or peripheral blood stem cells for multiple myeloma or breast cancer was performed to study whether this shorter duration of neutropenia can influence the risk of and the severity of infection. Patients who underwent peripheral blood stem cell transplantation (PBSCT) had faster engraftment than the group treated with autologous bone marrow transplantation (ABMT). Furthermore, the requirement for transfusions of red blood cells and platelets was a reduced. The number of days needed in hospital was significantly lower in PBSCT patients. No reduction in the frequency of infectious complications was found in PBSCT as compared with ABMT patients, but the numbers of days with fever and with antibiotic treatment were significantly lower in the PBSCT patients. Breast cancer patients had significantly faster engraftment but no fewer infectious complications than myeloma patients, regardless of the type of transplantation. Significantly lower numbers of clinically verified infections were found in the group of patients receiving colony-stimulating factors (CSF) after transplantation even though there was no difference in the duration of neutropenia. The need for antibiotic treatment was also significantly less in the group treated with CSF.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1433-7339
    Keywords: Acyclovir ; Bacteraemia ; Leukaemia induction treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We prospectively tested the hypothesis that prevention of herpes simplex virus infection with acyclovir might also reduce the incidence of bacterial infections in adult patients with acute leukaemia. During the first induction therapy a double-blind, randomized and placebo-controlled study was undertaken. Fifty-two patients were treated with 200 mg acyclovir orally four times daily throughout the induction period, whereas 55 patients received placebo. The groups were comparable with regard to age, cytotoxic chemotherapy and duration of neutropenia. Bacteraemias were significantly fewer in the acyclovir group (20 versus 41 episodes; P=0.007). The number of isolated microorganisms causing bacterial or fungal infections was also lower during acyclovir prophylaxis (52 isolates, versus 93 isolates; P=0.02). There was no significant differenc between the groups with regard to the number of clinically documented infections or fevers of unknown origin. Herpes simplex virus isolations occurred only in the placebo group (P=0.001). Thus, oral acyclovir prophylaxis was associated with reductions of all microbiologically documented infections suggesting that prevention of herpes simplex virus reactivation in acute leukaemia patients may reduce the occurrence of other infections.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-8798
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cellular reactivity to herpesviruses was studied after bone marrow transplantation (BMT). In 3 patients all virus-stimulated lymphocytes were of donor type. In the fourth patient, 14 per cent of the HSV stimulated cells were of recipient origin at 6 months after BMT.
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