Granulocyte colony-stimulating factor in secondary prophylaxis for advanced-stage Hodgkin lymphoma treated with ABVD chemotherapy: a cost-effectiveness analysis.

Granulocyte colony-stimulating factor (G-CSF) is commonly administered to patients with Hodgkin lymphoma (HL) with neutropenia. We constructed a decision-analytic model to compare the cost-effectiveness of secondary prophylaxis with G-CSF to a strategy of 'no G-CSF' in response to severe neutropenia for adults with advanced-stage HL treated with ABVD. A Canadian public health payer's perspective was considered and costs were presented in 2013 Canadian dollars. The quality-adjusted life years (QALYs) attained with the G-CSF and 'no G-CSF' strategies were 1.403 and 1.416, respectively. Costs for the strategies with and without G-CSF were $38,971 and $33,982, respectively. In the base case analysis, the 'no G-CSF' strategy was associated with cost savings and improved QALYs; therefore, 'no G-CSF' was the dominant approach. For patients with severe neutropenia during ABVD chemotherapy for advanced-stage HL, a strategy without G-CSF support is associated with improved quality-adjusted outcomes, cost savings, and is the preferred approach.

Antitumor effect of Pt(II) amine phosphonate complexes on sarcoma sa-180 in mice. Crystal structure of cis-dichlorobis(diethyl-4-pyridylmethylphosphonate-kappaN)platinum(II) hydrate, cis-[PtCl2(4-pmpe)2].H20.

The cisplatin analogoues platinum (II) complexes of the general formula cis-[PtL2Cl2], where L is monodentate diethyl 2-, 3- or 4-pyridylmethylphosphonate (2-, 3- or 4-pmpe) ligand, have been synthesized and characterized by means of IR and NMR (1H, 31P, 195Pt) spectroscopy. The crystal and molecular structure of cis-[Pt(4-pmpe)2 Cl2].H2O (A3) shows a square planar geometry of PtL2Cl2, with two organic molecules and two chloride leaving ligands in a cis configuration. The antitumor activity of the platinum (II) complexes was examined against Sarcoma Sa-180 in mice. The obtained results indicate a marked anticancer effect of platinum phosphonate complexes, and moderate nephrotoxicity evaluated in the BUN and creatinine levels in comparison with cisplatin (CDDP).

Phosphorohydrazines of 4-oxo-4H-1-benzopyran and 1-benzopyran-2,4-dione exhibit antitumor activity against L1210 leukemia.

Phosphorohydrazines and phosphorohydrazones of benzopyran-2,4-dione as well as the phosphorohydrazone of 4-hydroxycoumarine were tested for antitumor activity in lymphatic leukemia L1210 bearing mice.

[Tuberculous pleurisy--still difficult diagnostic problem]. / Gruzlicze zapalenie oplucnej--nadal trudny problem diagnostyczny.

In years 1989-2000 in Lung Diseases Hospital in Lódz tuberculous pleurisy TP was diagnosed in 271 patients; in 130 (48%) cases this diagnosis was confirmed by microbiological and histopathological examinations. Presence of tubercle bacilli in pleural fluid was discovered by smear and culture only in 13 cases, only by culture in 95 and in Bactec method in 7. During this period in 135 patients with pleural effusion of unknown etiology biopsy of the pleura (with Abrams needle) was performed and specific granuloma was found in 17 (13%) persons. In 15 (12%) patients it was the only method establishing diagnosis of TP (because in 2 remaining patients tubercle bacilli in pleural fluid were also found). Assessment of clinical symptoms indicates that onset of TP was insidious and course of the disease was subacute in about 30% of patients, manifested mainly by: fatigue, general weakness, night sweats. Radiological estimation of patients with TP disclosed (besides pleural effusion) lung infiltrations in 38 (28%) cases, including 13 (10%) with cavitation. Tuberculin induration with diameter 0 mm was found in 32% of patients with TP and with greater than 10 mm in 29% of patients. Because of low sensitivity of microbiological examinations of pleural fluid for tubercle bacilli biopsy of pleura should be method of choice in the diagnosis of TP in selected cases.

[Pseudomonas aerogunosa pneumonia in patients treated at the Hospital for Chest Diseases]. / Zapalenia pluc wywolane przez paleczke ropy blekitnej u chorych leczonych w Szpitalu Chorób Pluc.

Retrospective analysis of pneumonia caused by Pseudomonas aeruginosa was made in 66 patients, treated in hospital. Nosocomial pneumonia was diagnosed in 11 (17%) patients. In 51 patients coexisting lung diseases were present: mainly COPD and bronchiectasis. Strains of Pseudomonas aeruginosa were susceptible mostly to imipenem, meropenem, aztreonam, ticarcillin-clavulanic acid, ceftazidime, ciprofloxacin, amikacin, piperacillin-tazobactam, netilmicin. Duration of treatment in hospital was very long--59% were treated over 30 days. Combined antibacterial therapy was applied in 35 (53%) patients and monotherapy, often with different antibiotics--in 31 (47%) patients. Treatment was successful in 45 (68%) patients. In 9 patients the results of treatment was not successful: mainly because of empyema in 7 pts. Twelve (18%) patients (with coexisting COPD--6 and lung cancer--6) died. We can support current recommendations for treatment of Pseudomonas aeruginosa infection with combination of aminoglycosides or fluoroquinolones plus one of remaining antipseudomonal antibiotics. Treatment failures occurred mainly in patients with severe coexisting diseases and/or empyema.

The effective of methotrexate on immune response cells in rheumatoid arthritis.

Methotrexate (MTX) is one of the most used medicines in rheumatoid arthritis [r. a.] treatment. There are many scientific reports which present influence of MTX on inflammatory process. In many centers influence of MTX on cytokines level have been investigated. Thanks to clinical studies it has been performed that MTX holds up activity and productions of Il-8, releasing of TNF-alpha and reduction of concentration Il-6. MTX holds up proliferation of monocytes, macrophages and synoviocytes. It has been indicated that MTX decreases synthesis of B-4 leucotrien in neutrophils, decreases level of neutral proteases, holds up cellular immunity and has antiproliferative influence on endothelial cells. There are reports, that MTX reduces expression of endothelial cells adhesive proteins and synthesis of chemotactic factors, stopping migration of leucocytes to tissues.

Favourable interactions of cytostatic and steroid drugs in treatment of systemic lupus erythematosus.

Systemic lupus erythematosus (referred to below as SLE) is a disorder associated with formation of immune complexes in the circulatory system and their deposition in the internal organs, as well as in the skin. The disease can appear at any age, but the vast majority of cases are women between 15 and 40 years of age. The paper presents the case of a thirty-year-old woman with systemic lupus erythematosus. She was admitted to hospital because of erythematous and haemorrhagic lesions in the skin of her face, hands and feet and febrile states. SLE was diagnosed in the patient on the basis of criteria established by the American Rheumatological Association. The following abnormalities were observed in the patient: skin lesions of erythematous type on the face, hypersensitivity to UV light, erosions of the mucous membranes of the oral cavity, changes in the kidneys confirmed by biopsy, haematological symptoms, immune disorders. Additional criteria to establish the diagnosis included: febrile states. Raynaud's sign, hair loss, presence of immunoglobulin complexes in the skin, decreased complement level. The paper discusses modern therapy of visceral lupus erythematosus, based on corticosteroids and immunosuppressants. The interactions of these drugs were observed in the patient. The woman was treated with combined corticosteroid and cytostatic therapy, which led to the remission of the pathologic process confirmed by the clinical condition of the patient and laboratory tests.

Irritation of gastrointestinal mucosa by new glycosyl derivative of diclofenac in comparison with diclofenac in rats.

We have obtained new glycosyl derivative of diclofenac 3 and studied its ulcerogenic effect in the gastrointestinal system. Diclofenac as free acid 1 and its derivative 3 were administered to rats per os in a single dose 20 mg/kg and in 5 doses of 5 mg/kg. Single dose of derivative 3 caused less irritation than 1; after multiple administration no irritating effect of derivative 3 was seen.

[Pleural needle biopsy in the diagnostic standards of pleural diseases in the past and today]. / Biopsja iglowa oplucnej w standardzie diagnostyki chorób oplucnej wczoraj i dzis.

Pleural needle biopsy (PNB) maintained its value in spite of introduction of videothoracoscopy. Diagnostic possibilities of PNB using Abrams needle were evaluated during 1989-1998 in 114 patients aged 17-82 years. In histological examinations of the biopsy specimens were diagnosed: neoplasms--in 47 (41%) patients, tuberculosis--in 10 (9%) and chronic nonspecific pleuritis--in remaining 57 patients. Data from further course of the disease confirmed diagnosis of neoplasms and tuberculosis. Complication of PNB was encountered only in 1 patient (pneumothorax). Among 47 patients with malignant infiltration of the pleura in the biopsy specimen only in 20 (42%) neoplastic cells were demonstrated in cytologic examination of the pleural fluid. PNB remains still useful in the diagnosis of causes of pleural diseases. Specificity of this method can be enhanced by more precise localization of the pleural lesions using imaging technics (USG, CT, MRI). PNB should be more widely performed in the diagnosis of pleural diseases of unknown etiology particularly when videothoracoscopy is not feasible.

Synthesis and preliminary antileukemic studies of cyclic mitoguazone analogues.

Analogues of mitoguazone bearing a terminal amidino group as a part of the seven-membered ring of 1,3-diazepine and six-membered ring of pyrimidine were prepared in order to evaluate in vivo antileukemic action towards L1210 leukemia in mice. Preliminary pharmacological screening showed that the investigated compounds increase the life span (T/C%) of the treated mice in comparison with the untreated animals. The strongest antineoplastic effect was exhibited by compound 8.

[Staphylococcal pneumonia--analysis of material from patients treated at the Hospital for Lung Diseases in the years 1981-1994]. / Gronkowcowe zapalenia pluc--analiza materialu chorych leczonych w Szpitalu Chorób Pluc w latach 1981-1994.

Retrospective analysis of staphylococcal pneumonia was made in 182 patients, aged 18-88 years /61% more than 60 years old/ treated in hospital in years 1981-1994. Majority of these patients had various concomitant diseases, mostly chronic bronchitis and lung cancer. Strains of Staphylococcus aureus were sensitive mainly to amoxycillin--clavulanic acid, roxitromycin, amikacin, netilmicin, clindamycin, cefamandol, chloramphenicol, rifampicin and resistant mostly to penicillin /90% of strains/, ampicillin, tetracyclines. In many cases initial antibacterial treatment was inadequate in relation to sensitivity pattern of staphylococci--hence many changes of antibiotics were observed in the course of the therapy. Newer antistaphylococcal drugs were applied only in the last years of the study. Despite these therapeutical drawback outcome of staphylococcal pneumonia was good in 85% of patients; 14% of patients died /mainly as a consequence of comorbidities/. Successful therapy of staphylococcal pneumonia requires early recognition of possibility of infection due to Staphylococcus aureus and adjustment of drugs to probable or actual sensitivity of these pathogens.

[Pleural needle biopsy in diagnosis of pleural effusion]. / Biopsja oplucnej w rozpoznawaniu przyczyn wysieku oplucnej.

Diagnostic reliability of percutaneous parietal pleural biopsy with use of the Abrams needle technique performed over a period 1989-1994 was assessed in 37 patients with pleural effusion of unknown etiology, aged 24-82 years. Adequate diagnostic specimens were obtained in 33 patients. Histopathological diagnosis established neoplasma (39,4%), tuberculosis (9.1%) and chronic nonspecific pleuritis (51,5%). No complications of the procedure were encountered. Pleural needle biopsy should be more widely applied as a basic method in the diagnosis of pleural effusions of unknown etiology.

Synthesis and anticancer activity of 2-substituted 2,3-dihydro-1,3,2- benzoxazaphosphorin-4-one and its 2-oxide derivatives.

As a result of the reaction of salicylic amide with PCl3 and POCl3 2-chloro-2,3-dihydro-1,3,2-benzoxazaphosphorin-4-one (1) and its 2-oxide 2 are obtained. Compounds 1 and 2 form amides with amines in 2-position. Antineoplastic action of the derivatives containing the bis(2-chloroethyl)amide group in 2-position was found.

[Influence of benzyl penicillin on cytotoxicity and level of metabolic activity of cyclophosphamide in mice]. / Wplyw benzylopenicyliny na cytotoksycznosc i poziom aktywnych metabolitów cyklofosfamidu u myszy.

The influence of benzylpenicillin on cytotoxicity of cyclophosphamide (CF) against leukaemia L 1210 was studied. The level of CF metabolites in mouse serum was traced. The benzylpenicillin appeared to enhance cytotoxic activity of CF and leads to increase of active metabolites when CF applied in high doses (300 mg/kg).

[Synthesis and pharmacologic examination of derivatives of benzoxazaphosphoryl-4-one and 2-phenyl-10-methyl-3a-triethoxyphosphone-1H,2,3,9,10-tetrahydropyrrolo [3,4-b][1,4]benzoxazepine-1,3,9-trione]. / Synteza i badania farmakologiczne pochodnych benzoksazafosforyno-4-on i 2-fenylo-10-metylo-3a-trietoksyfosfonio-1H,2,3,9,10-tetrahydropirolo [3,4-b][1,4] benzoksazepino-1,3,9-trionu.

A series of N-derivatives of 2-phenyl-2,3-dihydro-1,3,2(lambda 5)- benzoxazaphosphoryl-4-one and 2-phenyl-10-methyl-3a-triethoxyphosphonio- 1H,2,3,9,10-tetrahydropyrrolo[3,4-b]([1,4]benzoxazepine-1,3,9-trio ne have been prepared. The pharmacological investigation of the above mentioned compounds shows antitumor action against leukaemia in the case of three N-derivatives.

[Effect of antifolates and folates on the antineoplastic action of fluoropyrimidines]. / Wplyw antyfolianów i folianów na przeciwnowotworowe dzialanie fluoropirymidyn.

The influence of folate and antifolate on the cytostatic activity of fluoropyrimidines has been examined extensively. From all of present work, it is apparent that methotrexate can be synergistic or antagonistic in its interaction with 5-fluorouracil, depending on the sequence used and the metabolic machinery present in the target cell. The interaction between commonly administered 5-fluorouracil and leucovorin may enhance carcinostatic efficacy of 5-fluorouracil in patients with colon carcinoma.