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  • 1
    Keywords: ADVANCED SOLID TUMORS ; CLASSIFICATION ; DIAGNOSIS ; ANTITUMOR-ACTIVITY ; MALIGNANCIES ; OUTCOMES ; ONCOLOGY ; RECOMMENDATIONS ; SELECTIVE INHIBITOR ; POLO-LIKE-KINASE-1
    Abstract: Polo-like kinases (Plks) play an important role in cell cycle checkpoint controls and are over-expressed in acute myeloid leukaemia (AML). BI 2536, a novel Plk inhibitor, induces mitotic arrest and apoptosis. In this phase I/II trial of BI 2536 in 68 elderly patients with relapsed/refractory AML, three schedules were investigated (day 1, days 1-3, and days 1 + 8). Maximum tolerated dose was 350 and 200 mg in the day 1 and days 1 + 8 schedules, respectively. The day 1-3 schedule appeared equivalent to the day 1 schedule and was discontinued early. BI 2536 exhibited multi-compartmental pharmacokinetic behaviour. The majority of patients showed an increase of bone marrow cells in G2/M with a characteristic pattern of mitotic catastrophe. The overall response rate in the day 1 and day 1 + 8 schedules was 9% (5/54) with 2 complete and 3 partial responses. The majority of drug-related adverse events grade 〉/=3 were haematological. Taken together, Plk inhibition induced cell cycle arrest in AML blasts in vivo and BI 2536 monotherapy showed modest clinical activity in this poor prognosis patient group.
    Type of Publication: Journal article published
    PubMed ID: 24033250
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  GMDS 2012; 57. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS); 20120916-20120920; Braunschweig; DOC12gmds147 /20120913/
    Publication Date: 2012-09-14
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 3
    ISSN: 1432-1041
    Keywords: Intraocular pressure, Alfentanil pretreatment ; suxamethonium, thiopentone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The effects of pretreatment with alfentanil on intraocular pressure (IOP) were investigated in 40 patients undergoing ophthalmic surgery. Patients were randomly allocated to two study groups. Group 1 patients (n=20) received alfentanil 15 μg · kg−1, vecuronium 0.01 mg · kg−1, thiopentone 3-4 mg · kg−1, and suxamethonium 1 mg · kg−1 for anaesthetic induction, whereas patients in group 2 (n = 20) received vecuronium 0.01 mg · kg−1, thiopentone 3–4 mg · kg−1, and suxamethonium 1 mg · kg−1. A total of seven measurements of intraocular pressure were taken in each patient, starting before premedication and ending after extubation of the trachea. In group 2 patients, there was an increase in IOP after endotracheal incubation. In group 1 patients, a decrease in IOP occurred which was related to the decrease in arterial blood pressure. We conclude that alfentanil pretreatment can prevent the increase in IOP following suxamethonium administration.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Der Anaesthesist 43 (1994), S. 699-717 
    ISSN: 1432-055X
    Keywords: Schlüsselwörter: Anästhesie – Koronare Herzerkrankung – Myokardischämie – Medikamentöse Therapie –Übersicht ; Key words: Anaesthesia – Coronary heart disease – Myocardial ischaemia – Drug therapy – Review
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract. Objective. The aim of our review is to summarize relevant data on the perioperative use of anti-ischaemic drugs in patients at risk for or with proven coronary heart disease. Data sources. The accessible medical literature according to current electronic information sources was explored. Results. One in every eight general anaesthetics is administered to a patient at risk for or with proven coronary heart disease. Of these patients, it is estimated that 20% – 40% have perioperative myocardial ischaemia (PMI), the majority being nonsymptomatic. This figure correlates with the occurrence of postoperative cardiac complications and myocardial infarction. The anaesthetist therefore has an important role to play in reducing the rate of perioperative cardiac sequelae. This can be achieved with good control of haemodynamic stability and the timely and appropriate use of antiischaemic drugs. Nitrocompounds (nitrates, molsidomine) serve as the gold standard in current angina pectoris treatment. Acting as coronary and systemic vasodilators, they effect an immediate reduction in preload and have been shown to be the drugs of first choice for intraoperative myocardial ischaemia. Beta-blockers reduce the rate of PMI to a greater extent than nitrates. They are also effective in myocardial ischaemia not accompanied by an increased heart rate. Single pre-operative administration of beta-blockers has also been shown to be beneficial in reducing theincidence of perioperative tachycardia, hypertension, and PMI. Consequently, such one-time medication can be considered for previously untreated high-risk patients presenting for surgery. The continuation of oral calcium channel blockers to the morning of surgery also reduces the rate of PMI and myocardial infarction in coronary-bypass patients, and combination with beta-blockers enhances this effect. Intra-operative diltiazem infusions are similarly advantageous in this patient group. In addition to nitrates, calcium antagonists are the drug of choice for coronary vasospasm. Drugs inhibiting platelet aggregation have a particular role in patients with coronary heart disease, however, they also cause increased perioperative bleeding. Consequently, it is recommended that these medications be discontinued 5 – 10 days prior to major surgery, with the exception of high-risk patients. Pilot studies using alpha2-agonists have shown reduced anaesthetic requirements and a reduction in PMI. The perioperative relevance of these drugs is currently being investigated. Conclusions. Beta-blockers, calcium channel blockers, nitrates, and possibly alpha2-agonists lead to reduced rates of PMI and other cardiac complications in risk patients. Current anti-anginal medications, with the exception of anti-platelet agents, should be maintained to the day of surgery and continued as soon as possible thereafter. All of these drugs except anti-platelet agents may also be used intra-operatively, however, possible interactions with anaesthetic agents should be carefully considered.
    Notes: Zusammenfassung. Jede 8. Anästhesie wird bei einem Patienten mit koronarer Herzerkrankung (KHK) bzw. bei Risikogruppen durchgeführt. Perioperativ finden sich bei diesen Patienten in 20 – 40% überwiegend klinisch stumme Myokardischämien. Diese korrelieren eindeutig mit der Rate postoperativer kardialer Komplikationen. Die Reduktion perioperativer kardialer Komplikationen ist eine wichtige Aufgabe des Anästhesisten. Neben einer hämodynamisch stabilen Führung kann dies durch den gezielten Einsatz antiischämischer Medikamente erreicht werden. NO-Donatoren (Nitrate, Molsidomin) bewirken eine koronare und systematische Gefäßdilatation mit konsekutiver akuter Verminderung der Füllungsdrucke. Bei intraoperativer Myokardischämie können Nitrate das Mittel der ersten Wahl darstellen. β-Blocker reduzieren die Ischämierate stärker als Nitrate. Sie wirken auch bei Ischämien, die nicht mit einem Anstieg der Herzfrequenz einhergehen und zeigen selbst bei einmaliger präoperativer Gabe günstige Effekte auf die perioperative Inzidenz von Hypertension, Tachykardien und Myokardischämien. Die Weiterführung einer chronischen oralen Therapie mit Kalziumantagonisten bis zum Morgen der Operation reduziert bei koronar-chirurgischen Patienten die Rate perioperativer Ischämien und Myokardinfarkte. β-Blocker verstärken diesen Effekt. Thrombozytenaggregationshemmer haben eine hohe prognostische Relevanz bei koronarkranken Patienten. Sie verursachen jedoch perioperativ eine signifikante Erhöhung der Blutungsrate. Von Hochrisikopatienten abgesehen wird daher das Absetzen dieser Substanzen 5 – 10 Tage vor einer größeren Operation empfohlen. Pilotstudien zeigen auch für α 2 -Agonisten eine Reduktion der Rate perioperativer Myokardischämien. Schlußfolgerung: β-Blocker, Kalziumantagonisten, NO-Donatoren und wahrscheinlich auch α 2-Antagonisten können bei Risikogruppen die Rate perioperativer Myokardischämien und folgender kardialer Komplikationen reduzieren. Eine chronische, antianginöse Medikation sollte daher mit Ausnahme der Thrombozytenaggregationshemmer bis zum Tag der Operation und postoperativ so früh als möglich weitergeführt werden. Bei einem intraoperativen Einsatz sind Interaktionen mit Anästhetika zu beachten.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 45 (1990), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: High-dose aprotinin for reduction of intra- and postoperative blood loss was associated with profound hypotension and flushing in a 3.5-year-old child who underwent cardiac surgery. Treatment with noradrenaline and intravenous fluid was required. Cardiovascular stability was restored after 10 minutes.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    ISSN: 1434-4726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Forty-seven children with congenital heart disease received ketamine 3 mg kg−1 intramuscularly as a pre-induction agent. During the 10 min observation period following ketamine administration no adverse cardiovascular or respiratory side-effects were seen. Arterial oxygen saturation as measured by pulse oximetry remained constant in all patients. In the group of children with cyanotic heart disease, there was a trend towards improvement of oxygen saturation which became significant 10 min after ketamine administration. We conclude that ketamine is a useful pre-induction agent when used in the appropriate dose range.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 45 (1990), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: One hundred and ten male patients scheduled for coronary artery bypass grafting were allocated randomly into one of three groups. Patients in group A received fentanyl 7 μg/kg via a central venous catheter, those in group B were given fentanyl 7 μg/kg through a peripheral venous cannula, and patients in group C received sterile water via a central venous catheter. In group A, 45.9% of patients coughed after injection of fentanyl; the mean onset time from the end of fentanyl administration to the beginning of coughing was 10.6 seconds. Only one patient in group B and no patient in the control group exhibited a cough response (p 〈 0.0001). We hypothesise that fentanyl can evoke the pulmonary chemoreflex.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1238
    Keywords: Central venous catheter ; Complications of jugular internal vein ; Embolization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of intraoperative internal jugular vein catheter embolization in a patient undergoing median sternotomy for open-heart surgery is described. This complication suggests that right sided cannulation of the internal jugular vein is to be preferred in all patients having a median sternotomy in order to avoid the risk of intersection by median sternotomy.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1238
    Keywords: Aluminium absorption ; Hyperaluminaemia ; Antacids ; Renal failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied the serum aluminium levels of 30 intensive care patients receiving six daily doses of magaldrate (Riopan®) or aluminium hydroxide (Trigastril®). In both groups we found a significant rise of the serum aluminium concentration (p〈0.01) following administration of the antacid solutions. Examination on day 9 and 15 the magaldrate group showed significantly (p〈0.05) lower aluminium levels than the aluminium hydroxide group. An increase up to the critical serum aluminium level of 100 ng/ml occurred in none of the patients that all had normal or slightly impaired renal function. Therefore routine measurements of serum aluminium levels in patients without renal impairment are not considered necessary following antacid therapy. However, we recommend the use of antacids with an aluminium absorption rate as low as possible.
    Type of Medium: Electronic Resource
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