The role of corrected QT interval in the cardiologic follow-up of young patients treated with Adriamycin.

UNLABELLED: The behavior over time of the corrected QT interval (QTc) in patients treated with Adriamycin (ADM) was evaluated in order to detect any possible correlations between the modifications of the QTc duration and the cardiac function of patients treated with different cumulative doses of ADM (360, 390, 480 mg/m2). PATIENTS AND METHODS: Electrocardiograms (ECGs) performed 2 months (178 patients), 1 year (65) and 3 years (43) after the completion of chemotherapy, were examined. RESULTS: after 2 months a prolonged QTc interval (> or = 0.45 sec) was found in 50% of patients, after 1 year in 26% and after 3 years in 14%. The patients treated with the highest dose of the drug (480 mg/m2) showed the highest incidence of prolonged QTc intervals. No patients treated with 360 mg/m2 ADM showed prolonged QTc intervals after 3 years. No correlations between prolonged QTc and functional echocardiographic alterations were noticed. The QTc interval prolongation, easily observable after treatment with ADM, seems to be related to the quantity of the drug administered and is generally a reversible phenomenon. Nevertheless a prolonged QTc can persist after 3 years. The persistence of prolonged QTc intervals is not associated with a higher incidence of functional cardiac deficits which are echocardiographically detectable.

Thromboembolism in total hip replacement.

The efficacy of low dosage heparin in the prevention of pulmonary embolism has been assessed in a group of 177 "high risk" patients undergoing hip replacement operations compared with a control group of 236 "high risk" patients not so treated. The diagnosis of pulmonary embolism was made on the basis of the commonly accepted clinical signs and symptoms, confirmed by electrocardiography, chest radiography, serum enzymes, and blood gas analysis. Pulmonary embolism occurred in 9.74% of the patients in the control group and in 1.69% of those treated with heparin. These figures indicate that heparin is effective in preventing pulmonary embolism.

[The association of local radiation therapy and systemic chemotherapy in the treatment of clinically localized Ewing's sarcoma]. / L'associazione terapia radiante locale - chemioterapia sistemica nel trattamento del sarcoma di Ewing clinicamente localizzato

The results obtained in 12 cases of still clinically localized Ewing's sarcoma by associating radiation therapy of the primary focus with intermittent systematic chemotherapy are reported. Two of these patients presented pulmonary and bone metastases 12 and 14 months respectively after bioptic diagnosis while the remaining ten were in good health and free from metastasis at between 6 and 28 months (average 16 months) after biopsy. Although it is considered necessary to make further observations before the association's validity is certain, it is considered that on this basis and on the basis of the few cases reported in the literature than the association of rationally conducted systematic chemotherapy with local radiation therapy will extend the onset time of metastasis and so increase average survival in Ewing's sarcoma.