analgesic - Department of Library Services

Database: Ovid MEDLINE(R) <2006 to March Week 3 2010>

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2 exp *analgesics/tu (7438)

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<1>

Unique Identifier

19589565

Status

MEDLINE

Authors

Phillips E. Hinck B. Pedro R. Makhlouf A. Kriedberg C. Hendlin K. Monga M.

Authors Full Name

Phillips, Elizabeth. Hinck, Bryan. Pedro, Renato. Makhlouf, Antoine. Kriedberg, Carly.

Hendlin, Kari. Monga, Manoj.

Institution

Department of Urologic Surgery, University of Minnesota and VAHCS Minneapolis,

Minneapolis, Minnesota 55455, USA.

Title

Celecoxib in the management of acute renal colic: a randomized controlled clinical trial.

Source

Urology. 74(5):994-9, 2009 Nov.

Abstract

OBJECTIVES: To evaluate the efficacy of celecoxib as an analgesic and medical expulsive agent in acute renal colic. METHODS: A prospective randomized double-blind study was conducted on patients presenting with an obstructing ureteral calculus < 10 mm in largest diameter. Patients were randomized to 400 mg of celecoxib, followed by 200 mg every 12 hours for 10 days, or to placebo. Patients with a solitary kidney, renal insufficiency (CR > 1.8), urinary tract infection, or significant cardiovascular disease were excluded. RESULTS: A total of 57 patients provided consent of which 53 completed the study. Four patients were excluded from the analysis because of stone passage or withdrawal of consent before the first dose of study medication. No significant difference was noted in the spontaneous stone passage rate (celecoxib 55.2%, placebo 54.2%) and between celecoxib and placebo with regard to days to stone passage (7.0 vs 9.0, P = .6) or size of stone passed (3.9 vs 4.6 mm, P = .18). No significant difference was noted in pain analog scores

(2.6 vs 3.5, P = .71) or narcotic doses (13.2 vs 13.6, P = .74). Furthermore, a 25% decrease in narcotic use (or 19 mg based on placebo mean) was outside the 80% one-sided confidence interval for the change in mean narcotic use between the 2 groups. Thus, it is unlikely (< 20%) that we missed a clinically significant beneficial effect of celecoxib on narcotic consumption because of sample size. CONCLUSIONS: Celecoxib does not facilitate stone passage or decrease narcotic requirements in patients with acute renal colic.

Publication Type

Journal Article. Randomized Controlled Trial. Research Support, Non-U.S. Gov't.

<2>


19546865

Status

MEDLINE

Authors

Biswas S. Eisen T.


Biswas, Swethajit. Eisen, Tim.

Institution

Freeman Hospital, Newcastle upon Tyne, UK.

Title

Immunotherapeutic strategies in kidney cancer--when TKIs are not enough. [Review] [95 refs]

Source

Nature Reviews Clinical Oncology. 6(8):478-87, 2009 Aug.

Abstract

FDA approval of the multitargeted, antiangiogenic tyrosine kinase inhibitors (TKIs) sunitinib and sorafenib, and the serine and threonine mammalian target of rapamycin inhibitor, temsirolimus, has revolutionized the management of metastatic clear-cell renal-cell carcinoma

(CC-RCC). The inability of these targeted therapies to provide durable complete responses, however, is a serious limiting factor to their clinical usefulness. Although immunotherapeutic approaches in advanced disease are increasingly regarded as a historical treatment paradigm, we propose that a fundamental understanding of immunobiology in CC-RCC can improve the selection of patients for high-dose intravenous interleukin 2 and facilitate the development of novel immunotherapeutic strategies. In our opinion, immunotherapeutic strategies have an important place in the management of advanced CC-RCC in the era of biological targeted therapy. [References: 95]


Journal Article. Review.

<3>


19371551

Status

MEDLINE

Authors

Eken C. Durmaz D. Erol B.


Eken, Cenker. Durmaz, Dilek. Erol, Bulent.

Institution

Akdeniz University Medical Faculty, Department of Emergency Medicine, 07059,

Antalya/Turkey. cenkereken@akdeniz.edu.tr

Title

Successful treatment of a persistent renal colic with trigger point injection.

Source

American Journal of Emergency Medicine. 27(2):252.e3-4, 2009 Feb.

Abstract

Renal colic is one of the painful conditions in emergency medicine practice. Opiates and nonsteroidal anti-inflammatory drugs are the cornerstone of pain management in renal colic.

However, alternative procedures should be considered in patients refractory to conventional therapies. We present a case of renal colic successfully treated by trigger point injection that was refractory to 150 microg fentanyl and 5 mg morphine.


Case Reports. Journal Article. Research Support, Non-U.S. Gov't.

<4>


18727615

Status

MEDLINE

Authors

Uzoh CC. Kumar V. Timoney AG.


Uzoh, Christopher C. Kumar, Vivekanandan. Timoney, Anthony G.

Institution

Department of Urology, Bristol Royal Infirmary, Bristol, UK. chrisc_uzoh@yahoo.com

Title

The use of capsaicin in loin pain-haematuria syndrome.

Source

BJU International. 103(2):236-9, 2009 Jan.

Abstract

OBJECTIVE: To highlight the implications of the use of capsaicin in managing loin painhaematuria syndrome (LPHS). PATIENTS AND METHODS: Between February 2002 and

February 2007, three patients (one male and two females; mean age 31.7 years) with LPHS were managed with capsaicin and followed up for a period of 8-48 months. All were diagnosed with

LPHS after negative urological investigations including urine culture, urine cytology, renal tract ultrasonography, intravenous urography and flexible cystoscopy; and nephrological work-ups including normal blood pressure measurements, creatinine clearance, urinary protein estimation and serum urea/creatinine. Five original papers were reviewed in detail for this article. Including our own experience, a total of 52 (including five bilateral) cases of LPHS treated with capsaicin are reviewed. RESULTS: Our patients received a total of four capsaicin instillations producing an average duration of pain relief per instillation of 17 weeks. There was evidence of renal deterioration in one, while another had worsened symptoms. The third patient continued his pain management within the pain clinic. The former two patients eventually underwent nephrectomy for poor function and extreme symptoms. CONCLUSION: Intrarenal capsaicin at best produces only short-term pain relief in more than half of patients with LPHS. It produces significant sideeffects, i.e. UTI, bladder pain, and in up to half of patients, deteriorating symptoms. Further loss of functional renal tissue and a nephrectomy rate of 20-67% should be weighed against the benefits. We have therefore abandoned its use in treating LPHS or renal pain, and recommend that patients should be adequately counselled on its potential side-effects, including nephrotoxicity and increased nephrectomy rate.


Case Reports. Journal Article.

<5>


19273566

Status

MEDLINE

Authors

Douglas C. Murtagh FE. Chambers EJ. Howse M. Ellershaw J.


Douglas, C. Murtagh, F E M. Chambers, E J. Howse, M. Ellershaw, J.

Institution

Ninewells Hospital, Dundee, UK. clairedouglas@nhs.net

Title

Symptom management for the adult patient dying with advanced chronic kidney disease: a review of the literature and development of evidence-based guidelines by a United Kingdom

Expert Consensus Group. [Review] [60 refs]

Source

Palliative Medicine. 23(2):103-10, 2009 Mar.

Abstract

Improvement in end-of-life-care is required for patients dying with chronic kidney disease

(CKD). The UK government now recommends that tools such as the Liverpool Care Pathway for the Dying Patient (LCP) be used to enhance the care of those patients dying with CKD. The LCP was originally developed for patients dying with terminal cancer, however has been shown to be transferable to patients dying with heart failure or stroke. On this background, in 2005 a UK

National Renal LCP Steering Group was formed. The aim was to determine whether or not the generic LCP was transferable to patients dying with CKD. An Expert Consensus sub-group was established to produce evidence-based prescribing guidelines to allow safe and effective symptom control for patients dying with renal failure. These guidelines were finalised by the Expert

Consensus group in August 2007 and endorsed by the Department of Health in March 2008. A literature search on symptom control and end-of-life care in renal failure was performed. A

summary of the evidence was presented at a National Steering Group meeting. Opinions were given and provisional guidelines discussed. A first draft was produced and individually reviewed by all members of the Expert Group. Following review, amendments were made and a second draft written. This was presented to the entire National Steering Group and again individual comments were taken into consideration. A third and fourth draft were written and individually reviewed, before the guidelines were finalised by the Expert Consensus group. Patients dying with advanced CKD suffer symptoms similar to patients dying of cancer. The Renal LCP prescribing guidelines aim to control the same symptoms as the generic LCP: pain, dyspnoea, terminal restlessness and agitation, nausea and respiratory tract secretions. The evidence for the production of the guidelines is discussed and how a consensus was reached. A summary of the guidelines is given and the complete guidelines document is available via the Marie Curie

Palliative Care Institute, Liverpool website. [References: 60]


Consensus Development Conference. Journal Article. Practice Guideline. Review.

<6>


18796350

Status

MEDLINE

Authors

Bodnar L. Wcislo G. Gasowska-Bodnar A. Synowiec A. Szarlej-Wcislo K. Szczylik C.


Bodnar, Lubomir. Wcislo, Gabriel. Gasowska-Bodnar, Agnieszka. Synowiec, Agnieszka.

Szarlej-Wcislo, Katarzyna. Szczylik, Cezary.

Institution

Department of Oncology, Military Institute of The Health Services, Warsaw, Poland. lubo@esculap.pl

Title

Renal protection with magnesium subcarbonate and magnesium sulphate in patients with epithelial ovarian cancer after cisplatin and paclitaxel chemotherapy: a randomised phase II study.

Source

European Journal of Cancer. 44(17):2608-14, 2008 Nov.

Abstract

BACKGROUND: The aim of this study was to examine the effect of magnesium supplementation on nephrotoxicity accompanying standard cisplatin-based chemotherapy in patients with epithelial ovarian cancer (EOC). PATIENTS AND METHODS: A double-blind, placebo-controlled, randomised study was conducted in which study arm magnesium sulphate (5 g) was administered before each course of standard chemotherapy with paclitaxel (135 mg/m(2)/24 h) plus cisplatin (75 mg/m(2)) every 3 weeks in patients with EOC. Magnesium subcarbonate (500 mg), three times per day orally, was administered during the treatment intervals. The control arm was administered a placebo instead of both magnesium salts.

Magnesium serum levels (sMg) and GFR markers: serum levels of creatinine (sCr), Cockroft-

Gault (ClCG) and Modification Diet of Renal Disease (MDRD) formulae were recorded before each cycle, and 3 weeks after the sixth course. RESULTS: 41 EOC patients were randomised and

40 were eligible. sMg varied significantly between the supplemented and placebo groups

(p<0.0001). The control group showed a significantly greater decrease of GFR assessed by: sCr

(p=0.0069), ClCG (p=0.0077) and MDRD (p=0.032) formulae compared with the magnesium supplemented group. CONCLUSIONS: These results demonstrate the nephroprotective effect of magnesium supplementation during chemotherapy with cisplatin.


Clinical Trial, Phase II. Journal Article. Randomized Controlled Trial. Research Support,

Non-U.S. Gov't.

<7>


17899475

Status

MEDLINE

Authors

Engeler DS. Schmid S. Schmid HP.


Engeler, D S. Schmid, S. Schmid, H P.

Institution

Klinik fur Urologie, Kantonsspital St. Gallen, St. Gallen, Switzerland. daniel.engeler@kssg.ch

Title

The ideal analgesic treatment for acute renal colic--theory and practice.

Source

Scandinavian Journal of Urology & Nephrology. 42(2):137-42, 2008.

Abstract

OBJECTIVE: With an annual incidence of 0.1-0.4%, renal colic is certainly a frequent disorder. Thanks to recent findings, the approach to treatment is changing. This prompted us to conduct a survey amongst all urologists in Switzerland regarding the analgesic measures they use in patients suffering from acute renal colic. MATERIAL AND METHODS: In March 2005, we sent a total of 170 questionnaires to all practising urologists who are also members of the Swiss

Urology Society. The questions covered the types of drugs used for first- and second-line analgesic therapy in acute renal colic and the approach to acute and follow-up analgesic therapy.

Dosage adjustments in patients with renal failure were also included. The responses were compared with recent literature findings and international guidelines. RESULTS: The response rate was 58%. Non-opioid analgesics are used for first-line therapy by 81% of respondents, with metamizol being used in 64% of cases. First-line therapy is given intravenously in 65% of cases.

An opioid (pethidine) is used most frequently as acute second-line therapy (74% of cases). In the presence of renal failure, half of the respondents make a dose adjustment to the analgesic.

Follow-up therapy consists mainly of non-steroidal anti-inflammatory drugs (75%). This complies with the literature and with the recommendations of the European Association of

Urology. CONCLUSION: First-line therapy for acute renal colic should consist of a non-opioid analgesic, and only if the response to this is inadequate should opioids then be used.


Comparative Study. Journal Article.

<8>


18430120

Status

MEDLINE

Authors

Signoretti S. Regan M. Atkins M.


Signoretti, Sabina. Regan, Meredith. Atkins, Michael.

Institution

Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston,

MA 02115, USA. ssignoretti@partners.org

Title

Carbonic anhydrase IX as a predictive biomarker of response to kidney cancer therapy.

[Review] [36 refs]

Source

BJU International. 101 Suppl 4:31-5, 2008 Jun.



<9>


18430119

Status

MEDLINE

Authors

Shuch B. Li Z. Belldegrun AS.


Shuch, Brian. Li, Zhenhua. Belldegrun, Arie S.

Institution

David Geffen School of Medicine, University of California-Los Angeles (UCLA), Los Angeles,

CA 90095-1738, USA.

Title

Carbonic anhydrase IX and renal cell carcinoma: prognosis, response to systemic therapy, and future vaccine strategies. [Review] [55 refs]

Source

BJU International. 101 Suppl 4:25-30, 2008 Jun.



<10>


18279450

Status

MEDLINE

Authors

Gore ME. De Mulder P.


Gore, Martin E. De Mulder, Pieter.

Institution

Royal Marsden Hospital, London, UK.

Title

Establishing the role of cytokine therapy in advanced renal cell carcinoma. [Review] [54 refs]

Source

BJU International. 101(9):1063-70, 2008 May.

Abstract

Tribute to Professor Pieter De Mulder, from Martin Gore. Pieter and I were often pitted against each other in debates at international meetings on the role of cytokine therapy. The truth is that there was little disagreement between us, but we both thought such set pieces were a good way to highlight the issues surrounding the use of cytokines. He wanted our true joint view to be put on record, and the result is this article. Pieter himself suffered from kidney cancer for many years and he died in April as we were putting the finishing touches to this manuscript. Pieter was a remarkable man in so many ways. He was a physician of great compassion, immense intellect, utter integrity and unshakeable scientific rigor. These qualities meant that his perspective on many clinical controversies was in great demand internationally. The European oncology community has lost one of its giants and I, a dear friend. This manuscript is dedicated to the memory of Professor Pieter de Mulder. [References: 54]



<11>


17970642

Status

MEDLINE

Authors

Giannitsas K. Konstantinopoulos A. Perimenis P.


Giannitsas, Konstantinos. Konstantinopoulos, Agelis. Perimenis, Petros.

Institution

University Hospital, Department of Urology, Patras, Greece.

Title

Non-steroidal anti-inflammatory drugs in the treatment of genitourinary malignancies: focus on clinical data. [Review] [72 refs]

Source

Expert Opinion on Investigational Drugs. 16(11):1841-9, 2007 Nov.

Abstract

The antitumour activity of NSAIDs in preclinical trials has lead to their evaluation in the management of various malignancies in humans. Evidence regarding their use in the treatment of genitourinary tumours is reviewed here, focusing primarily on clinical data. The majority of available evidence comes from meeting abstracts and only a few published manuscripts were detected. The efficacy of selective COX-2 inhibitors, a subcategory of anti-inflammatory drugs, is promising in prostate cancer, in either biochemical recurrence after initial treatment or advanced disease. This does not seem to be the case for renal tumours in which efficacy in the advanced disease setting is not satisfactory. Despite the well-documented rationale for the application of NSAIDs in bladder cancer management, clinical evidence is not available. More studies are needed to assess the efficacy of anti-inflammatory agents in bladder cancer treatment and further clarify their therapeutic benefit in patients with prostate cancer, in which initial results are encouraging. [References: 72]



<12>


17844723

Status

MEDLINE

Authors

Murtagh FE. Chai MO. Donohoe P. Edmonds PM. Higginson IJ.


Murtagh, Fliss E M. Chai, Mee-Onn. Donohoe, Paul. Edmonds, Polly M. Higginson, Irene J.

Institution

Department of Palliative Care & Policy, Kings College, London. fliss1@doctors.org.uk

Title

The use of opioid analgesia in end-stage renal disease patients managed without dialysis: recommendations for practice. [Review] [89 refs]

Source

Journal of Pain & Palliative Care Pharmacotherapy. 21(2):5-16, 2007.

Abstract

The numbers of patients dying with end-stage renal disease (ESRD), particularly those managed conservatively (without dialysis) or withdrawing from dialysis is increasing rapidly in developed countries. There is growing awareness of the extensive symptom control needs of these patients.

Pain is a common problem, and has been both under-recognized and under-treated. It is challenging to manage, largely because of the constraints very poor renal function places on use of medication. Although pharmacological reviews of opioid use in renal failure have been published, there is a need for clinical recommendations to aid palliative and renal specialists in providing effective pain control. This review describes the pharmacological evidence for and against the use of the different opioid medications, and translates this into clinical recommendations for ESRD patients managed conservatively, not for those on dialysis for whom there are different pharmacological considerations. Acetaminophen (paracetamol) is recommended at Step 1 of the World Health Organization ladder. Of the Step 2 analgesics, tramadol is the least problematic, although dose reduction and increased dosing interval are required, and caution should be exercised. Of the Step 3 analgesics, fentanyl, alfentanil and methadone are recommended. There is limited evidence for buprenorphine, although theoretical reasons why it may be a good choice for these patients. Hydromorphone and oxycodone cannot be recommended because of extremely limited evidence, although each is likely a better choice than morphine or diamorphine. Morphine and diamorphine themselves are not recommended because of known accumulation of potentially toxic metabolites. [References: 89]



<13>


17571256

Status

MEDLINE

Authors

Sanchez-Carpena J. Dominguez-Hervella F. Garcia I. Gene E. Bugarin R. Martin A. Tomas-

Vecina S. Garcia D. Serrano JA. Roman A. Marine M. Mosteiro ML. Dexketoprofen Renal

Colic Study Group.


Sanchez-Carpena, Juan. Dominguez-Hervella, Fermin. Garcia, Ignasi. Gene, Emili. Bugarin,

Rosendo. Martin, Angel. Tomas-Vecina, Santiago. Garcia, Dolors. Serrano, Jose Antonio.

Roman, Antonio. Marine, Miguel. Mosteiro, Maria Luisa. Dexketoprofen Renal Colic Study

Group.

Institution

Emergency Department, Hospital Universitario Dr. Peset, Valencia, Spain. sanchez_juacar@gva.es

Title

Comparison of intravenous dexketoprofen and dipyrone in acute renal colic.

Source

European Journal of Clinical Pharmacology. 63(8):751-60, 2007 Aug.

Abstract

OBJECTIVE: The aim of this study was to assess the efficacy and safety of a single intravenous

(i.v.) bolus of dexketoprofen trometamol compared with an i.v. infusion of dipyrone in patients with moderate to severe pain due to renal colic. METHODS: A total of 308 patients with renal colic and visual analog scale (VAS) score >/=40 mm participated in a multicenter, randomized, double blind, double-dummy, parallel, and active-controlled study and were randomized to dexketoprofen 25 mg (n = 101), dexketoprofen 50 mg (n = 104), and dipyrone 2 g (n = 103).

RESULTS: Mean [+/- standard deviation (SD)] total pain relief (TOTPAR) scores were similar in the dexketoprofen 50 mg (15.3 +/- 8.6) and dipyrone (15.5 +/- 8.6) and slighly higher than in dexketoprofen 25 mg (13.5 +/- 8.6), although significant differences were not achieved. In the same way, patients in the dexketoprofen 50 mg and dipyrone groups showed higher scores in the sum of pain intensity differences (SPID) and the sum of analogue pain intensity differences

(SAPID) than patients in the dexketoprofen 25 mg group, reaching statistical significance in comparison with dexketoprofen 25 mg and dipyrone for SPID and SAPID (p < 0.05). The timeeffect course for pain intensity differences and pain relief showed significantly higher values for both doses of dexketoprofen during the first 30 min after drug administration (p < 0.05).

Dexketoprofen 50 mg and dipyrone groups had 66% and 70%, respectively, of patients with at least 50% of maximum obtainable TOTPAR in comparison with 56% in the dexketoprofen 25 mg group. The study medications were well tolerated. CONCLUSIONS: Dexketoprofen 50 mg administered as a single i.v. bolus was effective for the relief of moderate to severe pain in patients with renal colic, with a good safety profile and efficacy similar to i.v. dipyrone 2 g.

Dexketoprofen produced analgesia that was faster in onset.


Comparative Study. Journal Article. Multicenter Study. Randomized Controlled Trial.

<14>


17370094

Status

MEDLINE

Authors

Paredes A.


Paredes, Ana.

Title

Can mycophenolate mofetil substitute cyclophosphamide treatment of pediatric lupus nephritis?. [Review] [20 refs]

Source

Pediatric Nephrology. 22(8):1077-82, 2007 Aug.

Abstract

Intravenous cyclophosphamide (CYC) has been the standard of care to induce remission of severe and active lupus nephritis for more than 20 years. Potential side effects are significant, and failure to achieve remission is still high. Mycophenolate mofetil (MMF) has emerged as a potential alternative to CYC, with an improved safety profile thus far. Results of two mayor randomized controlled trials in adults indicate no evidence of inferiority in patients treated with

MMF, less adverse events, and higher rate of complete remission. Experience in the pediatric population is very limited. Thus far, the efficacy, toxicity, and tolerability record of MMF in adults makes it an acceptable alternative to CYC in the induction phase of treatment. Early treatment is desired. Several questions remain: the optimal dose and length of induction with

MMF are unknown, the effect of MMF in severe cases of lupus nephritis with renal failure at presentation is unknown, and the compliance with long-term oral treatment in the adolescent population is certainly unknown. In this review, intravenous (IV) CYC induction in the sickest patients (renal failure at presentation) is considered and/or when compliance with oral treatment cannot be established. Also, MMF induction in reliable patients with mostly preserved renal function is considered. Most likely, MMF will serve as a therapeutic bridge between the previously well-known, broad-spectrum immunosuppressive drugs and the new, targeted biological agents. [References: 20]


Comparative Study. Editorial. Review.

<15>


17495435

Status

MEDLINE

Authors

Kawamura T.


Kawamura, Tetsuya.

Institution

Department of Medicine, Division of Kidney and Hypertension, Jikei University School of

Medicine, Tokyo, Japan.

Title

Treatment of IgA nephropathy: corticosteroids, tonsillectomy, and mycophenolate mofetil.


Source

Contributions to Nephrology. 157:37-43, 2007.

Abstract

Previous studies exploring the potential of glucocorticoid therapy on proteinuria and renal survival of patients with IgA nephropathy (IgAN) indicate that corticosteroid therapy is recommended if the patients show a moderate degree of proteinuria and their creatinine clearance exceeds 70 ml/min, although these studies, most of which are not prospective or randomized, have not provided conclusive results. Recently, Pozzi et al. demonstrated that treatment with glucocorticoids for 6 months significantly improved renal survival and proteinuria for 10 years of follow-up. A recent meta-analysis by Samuels et al. supports the use of corticosteroids in reducing proteinuria and preventing progression to end-stage renal disease.

Increasing attention has been drawn to the role of tonsillectomy in the longterm prognosis of

IgAN. The notion that tonsillectomy not only helps to prevent episodic macroscopic hematuria in the short-term but also gives long-term renal protection in IgAN is supported by two large retrospective studies from Japan. A study of 329 patients with IgAN by Hotta et al. found that tonsillectomy plus high-dose methylprednisolone was identified as one of the independent variables in predicting remission of clinical findings and lack of renal progression. Moreover, Xie et al. have reported that, for 20 years of follow-up, renal survival was significantly better in IgAN patients who underwent tonsillectomy than those who did not undergo the procedure. However, the role of tonsillectomy in the long-term prognosis of IgAN remains unclear, since it has not yet been tested in a controlled randomized trial. The role of mycophenolate mofetil (MMF) in IgAN

has been examined in four major trials. Two prospective randomized studies report no benefit from MMF. The remaining two studies showed a greater reduction of proteinuria in patients treated with MMF compared to prednisone or placebo. In both studies, however, MMF did not effectively modify the progressive course of the disease. Thus, despite promising results in large randomized controlled trials in lupus nephritis, the evidence for the use of MMF in IgAN is inconclusive. [References: 16]



<16>


17441929

Status

MEDLINE

Authors

Turner JS. Cheung EM. George J. Quinn DI.


Turner, Jeffrey S. Cheung, Eric M. George, Jaya. Quinn, David I.

Institution

Kenneth J. Norris Jr Comprehensive Cancer Center, Keck School of Medicine, University of

Southern California, Los Angeles, CA 90033, USA.

Title

Pain management, supportive and palliative care in patients with renal cell carcinoma. [Review]

[106 refs]

Source

BJU International. 99(5 Pt B):1305-12, 2007 May.



<17>


17255299

Status

MEDLINE

Authors

McDermott DF.


McDermott, David F.

Institution

Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA. dmcdemo@bidmc.harvard.edu

Title

Update on the application of interleukin-2 in the treatment of renal cell carcinoma. [Review] [28 refs]

Source

Clinical Cancer Research. 13(2 Pt 2):716s-720s, 2007 Jan 15.

Abstract

High-dose bolus interleukin 2 (IL-2) was granted Food and Drug Administration approval based on its ability to produce durable complete responses in a small number of patients with metastatic renal cell carcinoma. Results from randomized phase 3 trials suggest that regimens involving lower doses of IL-2, either alone or in combination with IFN, produce fewer tumor regressions of less overall quality. Given the toxicity, expense, and limited efficacy of this treatment, recent studies have focused on identifying predictors of response (or resistance) to IL-

2 therapy. This year, investigators launched a clinical trial designed to prospectively determine if patients who are more likely to respond to high-dose IL-2 can be identified before starting therapy. As the list of effective therapies for metastatic renal cell carcinoma grows, improvements in patient selection will be necessary to ensure that patients who might attain a durable remission with IL-2 will not miss this opportunity. [References: 28]


Journal Article. Research Support, N.I.H., Extramural. Review.

<18>


17206893

Status

MEDLINE

Authors

Mortelmans LJ. Desruelles D. Baert JA. Hente KR. Tailly GG.


Mortelmans, Luc J M. Desruelles, Didier. Baert, Joost A. Hente, K Robert. Tailly, Geert G.

Institution

Department of Emergency Medicine, AZ KLINA, Brasschaat, Belgium.

Luc.mortelmans@klina.be

Title

Use of tramadol drip in controlling renal colic pain.

Source

Journal of Endourology. 20(12):1010-5, 2006 Dec.

Abstract

BACKGROUND AND PURPOSE: Although the continuous perfusion of antispasmodic drugs has been the traditional mainstay in the treatment of renal colic, the results more often than not are unsatisfactory. Our hypothesis was that a continuous intravenous (IV) drip of tramadol would be an effective and safe alternative. PATIENTS AND METHODS: In this prospective study, 300 patients with renal colic were randomized into four treatment groups, single blind for the patients. At the start, all received an anti-inflammatory drug intramuscularly and an antiemetic and antispasmodic IV. Group A was given the classical IV antispasmodic perfusion combined with a sham drip. Group B received the classical antispasmodic perfusion in combination with a tramadol drip. Group C had a sham perfusion and drip. Group D received a sham perfusion and tramadol drip. There was no significant difference in the degree of pain between the groups on a visual analog scale (VAS) at the start. The pain was scored again on the

VAS at 30 minutes, 1 hour, and 4 hours after the start of the treatment and at IV urography.

Side effects, as well as the need for rescue medication, were registered. RESULTS: Both tramadol groups scored significantly better after 60 and 240 minutes and during IV urography

(P < 0.005). There was a significant decrease in VAS in group B after 30 minutes. The tramadol groups needed significantly less rescue medication (P = 0.001). There was no significant difference in the reported side effects. The combination spasmolytic-tramadol drip scored the best, although the difference was not statistically significant. CONCLUSION: We consider our hypothesis proved that a continuous tramadol drip is a safe and valuable analgesic regimen in renal colic.


Journal Article. Randomized Controlled Trial.

<19>


17190690

Status

MEDLINE

Authors

Srinivasjois RM. Nathan EA. Doherty DA. Patole SK.


Srinivasjois, R M. Nathan, E A. Doherty, D A. Patole, S K.

Institution

Department of Neonatal Paediatrics, King Edward Memorial Hospital for Women, Perth,

Australia.

Title

Renal impairment associated with indomethacin treatment for patent ductus arteriosus in extremely preterm neonates--is postnatal age at start of treatment important?.

Source

Journal of Maternal-Fetal & Neonatal Medicine. 19(12):793-9, 2006 Dec.

Abstract

OBJECTIVE: To study serum creatinine (SCr) levels following indomethacin for patent ductus arteriosus (PDA) closure in extremely preterm neonates in relation to postnatal age at the start of treatment. METHODS: This was a retrospective (January 2000-December 2002) analysis of data on preterm neonates (gestation <29 weeks) who received indomethacin for PDA. Pre-existing renal malformation and/or impairment and high serum levels of nephrotoxic drugs were criteria for exclusion. RESULTS: Indomethacin was commenced at postnatal age <7 days and >or=7 days in 60 (group 1) and 30 (group 2) neonates, respectively. The median (Q1, Q3) gestational age and birth weight for group 1 and group 2 neonates were 25 (23, 27) vs. 25 (24, 26) weeks and 740

(620, 909) vs. 780 (663, 966) grams, respectively. Postnatal age <7 days at start of indomethacin was associated with higher baseline (0.083 (0.074, 0.090) vs. 0.073 (0.054, 0.083) mmol/L, p=0.001) and peak SCr levels (0.099 (0.089,0.109) vs. 0.090 (0.064, 0.104) mmol/L, p=0.015). Logistic regression analysis controlling for gestational age and baseline SCr level indicated that postnatal age >or=7 days was a risk factor for elevated SCr after indomethacin (OR=13.4, 95% CI: 3.8-

46.6, p < 0.001). CONCLUSION: Postnatal age >or=7 days at the start of indomethacin is a predictor of a significant rise in SCr in extremely preterm neonates.


Journal Article.

<20>


17045087

Status

MEDLINE

Authors

McDermott DF. Atkins MB.


McDermott, David F. Atkins, Michael B.

Institution

Beth Israel Deaconess Medical Center and the Dana-Farber/Harvard Cancer Center Renal

Cancer Program, Boston, MA 02215, USA. dmcdermo@bidmc.harvard.edu

Title

Interleukin-2 therapy of metastatic renal cell carcinoma--predictors of response. [Review] [32 refs]

Source

Seminars in Oncology. 33(5):583-7, 2006 Oct.

Abstract

For the past 15 years, immunoreactive cytokines have been the mainstay of treatment for metastatic renal cancer. High-dose bolus interleukin-2 (IL-2) was granted US Food and Drug

Administration (FDA) approval in 1992 based on its ability to produce durable complete responses (CRs) in a small number of patients. Unfortunately, the toxicity, expense, and restricted accessibility of high-dose IL-2 make it a poor standard therapy. Regimens involving lower doses of IL-2 either alone or in combination with interferon (IFN) have generally produced fewer tumor regressions and these regressions were of less overall quality. Recent efforts have focused on trying to identify factors predictive of response to IL-2 therapy so that this treatment can be limited to those most likely to benefit. This year, investigators will launch a clinical trial designed to prospectively determine if patients who are more likely to respond to high-dose IL-2 can be identified prior to starting therapy. [References: 32]


Journal Article. Research Support, N.I.H., Extramural. Research Support, Non-U.S. Gov't.

Review.

<21>


17026799

Status

MEDLINE

Authors

McDermott DF. Regan MM. Atkins MB.


McDermott, David F. Regan, Meredith M. Atkins, Michael B.

Institution

Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. dmcdermo@bidmc.harvard.edu

Title

Interleukin-2 therapy of metastatic renal cell carcinoma: update of phase III trials. [Review] [43 refs]

Source

Clinical Genitourinary Cancer. 5(2):114-9, 2006 Sep.

Abstract

High-dose bolus interleukin-2 (IL-2) was granted Food and Drug Administration approval for the treatment of metastatic renal cell carcinoma based on its ability to produce durable responses in a small number of patients. Results from randomized phase III trials suggest that regimens involving lower doses of IL-2 alone or in combination with interferon produce fewer tumor regressions of decreased overall quality. Because of the toxicity and limited efficacy of this treatment, recent studies have focused on identifying predictors of response (or resistance) to IL-

2 therapy. This year, investigators will launch a clinical trial designed to prospectively determine whether patients who are more likely to respond to high-dose IL-2 can be identified before therapy is initiated. [References: 43]


Journal Article. Research Support, N.I.H., Extramural. Review.

<22>


16953530

Status

MEDLINE

Authors

Safdar B. Degutis LC. Landry K. Vedere SR. Moscovitz HC. D'Onofrio G.


Safdar, Basmah. Degutis, Linda C. Landry, Keala. Vedere, Swarupa R. Moscovitz, Harry C.

D'Onofrio, Gail.

Institution

Section of Emergency Medicine, Yale University School of Medicine, New Haven, CT 06519,

USA. basmah.safdar@yale.edu

Title

Intravenous morphine plus ketorolac is superior to either drug alone for treatment of acute renal colic.

Comments

Comment in: CJEM. 2008 Jan;10(1):66-8; PMID: 18226320]

Source

Annals of Emergency Medicine. 48(2):173-81, 181.e1, 2006 Aug.

Abstract

STUDY OBJECTIVE: To study the efficacy of intravenous ketorolac, morphine, and both drugs in combination in reducing pain in acute renal colic. METHODS: We conducted a prospective, double-blinded, randomized controlled trial in an urban, teaching emergency department. Patients aged 18 to 55 years and with a clinical diagnosis of acute renal colic and a pain rating greater than 5 on a 10-cm visual analogue scale or at least "moderate pain" on a 4category verbal pain scale were eligible for inclusion. Exclusion criteria were contraindication to nonsteroidal anti-inflammatory drugs or opiates, a history of drug dependence, presence of peritonitis, or analgesics within 6 hours of presentation. Patients received either morphine 5 mg at time zero and 5 mg at 20 minutes, ketorolac 15 mg at time zero and 15 mg at 20 minutes, or a combination of both. Primary outcomes were pain reduction and the need for rescue analgesia at

40 minutes. RESULTS: Of the 555 consecutive patients screened, 158 patients met inclusion criteria and 130 patients were randomized during 6 months. Mean difference in change in pain

score (visual analog scale 40 minutes minus visual analog scale 0 minutes) between combination group and morphine group was 1.8 cm (95% confidence interval [CI] -3.3 to -0.1) and, compared to the ketorolac group, was 2.2 cm (95% CI -3.7 to -0.5); P<.003. Patients with combination therapy were less likely to require rescue morphine compared to the morphine group (odds ratio

0.2; 95% CI 0.1 to 0.7; P=.007). CONCLUSION: A combination of morphine and ketorolac offered pain relief superior to either drug alone and was associated with a decreased requirement for rescue analgesia.


Comparative Study. Journal Article. Randomized Controlled Trial. Research Support, Non-

U.S. Gov't.

<23>


16895283

Status

MEDLINE

Authors

Johnson J. Weinryb J.


Johnson, Jerry. Weinryb, Joan.

Institution

Division of Geriatric Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. jcjohnson@mail.med.upenn.edu

Title

Safe pharmacologic treatment strategies for osteoarthritis pain in African Americans with hypertension, and renal and cardiac disease. [Review] [64 refs]

Source

Journal of the National Medical Association. 98(7):1126-35, 2006 Jul.

Other ID

Source: NLM. PMC2569481

Abstract

Arthritis is the leading cause of disability in the United States. Osteoarthritis, the most common form of arthritis, is a degenerative joint disease affecting both whites and African Americans similarly. African Americans have a high incidence rate of comorbidities, including hypertension, cardiovascular disease (CVD) risk factors and diabetes. Treatment of osteoarthritic pain in patients with comorbidities is often complicated by potential safety concerns. Traditional nonsteroidal antiinflammatory drugs (NSAIDs) and cyclooxygenase 2 (COX-2) specific NSAIDs have been shown to increase blood pressure in hypertensive patients taking antihypertensive medications. Patients with CVD risk factors taking low-dose aspirin for secondary prevention may be at increased risk for gastrointestinal bleeding with NSAIDs. Diabetics face an increased risk of renal complications. Because NSAIDs are associated with adverse renal effects, they should be used cautiously in patients with advanced renal disease. Acetaminophen is the most appropriate initial analgesic for African Americans with chronic osteoarthritic pain and concurrent hypertension, CVD risk factors or diabetes, and is recommended by the American

College of Rheumatology as first-line treatment. Many of the adverse effects commonly associated with NSAIDs are not associated with acetaminophen. Safety concerns surrounding pharmacologic treatment of osteoarthritis in African Americans are reviewed. [References: 64]


Journal Article. Research Support, Non-U.S. Gov't. Review.

<24>


16705027

Status

MEDLINE

Authors

Lee S. Moon SO. Kim W. Sung MJ. Kim DH. Kang KP. Jang YB. Lee JE. Jang KY. Lee

SY. Park SK.


Lee, Sik. Moon, Sang-Ok. Kim, Won. Sung, Mi Jeong. Kim, Duk Hoon. Kang, Kyung Pyo.

Jang, Yong Bum. Lee, Jung Eun. Jang, Kyu Yun. Lee, Sang Yong. Park, Sung Kwang.

Institution

Department of Internal Medicine, Chonbuk National University Medical School, 634-18, Keum-

Am Dong, Jeonju 561-712, Republic of Korea.

Title

Protective role of L-2-oxothiazolidine-4-carboxylic acid in cisplatin-induced renal injury.

Source

Nephrology Dialysis Transplantation. 21(8):2085-95, 2006 Aug.

Abstract

BACKGROUND: Oxidative stress and inflammation are implicated in the pathogenesis of cisplatin-induced nephrotoxicity. l-2-oxothiazolidine-4-carboxylic acid (OTC) is a cysteine prodrug, and increases cellular glutathione (GSH). OTC is converted to cysteine by the intracellular enzyme, oxoprolinase. To date, the protective role of OTC on cisplatin-induced renal injury has not been investigated. The purpose of the present study was to examine the protective effect of OTC on cisplatin-induced renal injury and to examine the mechanism of its protection. METHODS: Mice were treated with cisplatin with or without administration of OTC.

The generation of reactive oxygen species (ROS), expression of intercellular adhesion molecule

(ICAM)-1 and monocyte chemoattractant protein (MCP)-1 were determined in the kidney using

2',7'-dichlorofluorescein diacetate, immunostaining or western blot analysis. Nuclear factor (NF)kappaB activity, infiltration of F4/80-positive cells and apoptosis were also investigated in addition to renal function and histology using electrophoretic mobility shift assay, immunostaining, western blot analysis, uridine triphosphate (dUTP) nick-end labelling or periodic acid-Schiff staining. The effect of OTC on superoxide dismutase activity and GSH level in cisplatin-treated normal adult human kidney (HK-2) cells were measured using assay kits.

RESULTS: The administration of OTC resulted in a significant reduction of cisplatin-induced

ROS production, the p65 subunit of NF-kappaB translocation into nucleus, expression of ICAM-

1, caspase 3 activity, expression of MCP-1 and the infiltration of macrophages into renal tissue.

OTC markedly ameliorated renal damage induced by cisplatin through antioxidant and antiinflammatory effect. CONCLUSIONS: These results suggest that OTC can be a potential therapeutic agent in cisplatin-induced renal injury through decreasing the ROS levels and activation of NF-kappaB.


Journal Article. Research Support, Non-U.S. Gov't.

<25>


16756637

Status

MEDLINE

Authors

Kahvecioglu S. Dilek K. Akdag I. Gullulu M. Demircan C. Ersoy A. Yurtkuran M.


Kahvecioglu, Serdar. Dilek, Kamil. Akdag, Ibrahim. Gullulu, Mustafa. Demircan, Celalettin.

Ersoy, Alpaslan. Yurtkuran, Mustafa.

Institution

Department of Nephrology, Uludag University Medical School, Bursa, Turkey. kserdar@uludag.edu.tr

Title

Effect of indomethacin and selective cyclooxygenase-2 inhibitors on proteinuria and renal function in patients with AA type renal amyloidosis.

Source

Nephrology. 11(3):232-7, 2006 Jun.

Abstract

AIMS: Because the cardiovascular system (CVS) side-effects of cyclooxygenase-2 (COX-2) selective inhibitors have recently been questioned, we aimed to compare the renal and haemodynamic effects of cyclooxygenase selective (celecoxib and rofecoxib) and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) (indomethacin) in patients with renal

amyloidosis secondary to rheumatological diseases who required anti-inflammatory agents and are taking maximum tolerable dose of angiotensin-converting enzyme inhibitors. METHODS:

The present study was performed on 11 patients with stable proteinuria who were diagnosed as

AA amyloidosis secondary to rheumatological diseases confirmed by renal biopsies. The study had three consecutive stages (celecoxib 200 mg/day; indomethacin 100 mg/day; rofecoxib 25 mg/day.) Each was given for 4 weeks and a wash-out phase of 3 weeks was allowed between consecutive stages. RESULTS: Although the decrease of proteinuria in the celecoxib period was higher than in the rofecoxib and indomethacin periods, the difference was not statistically significant. No statistically significant differences were found between serum urea, creatinine, creatinine clearance and urinary sodium excretion. CONCLUSION: In this study, no differences were found between indomethacin and the two selective COX-2 inhibitors in respect to proteinuria and renal functions in 11 patients with renal amyloidosis secondary to rheumatological diseases with varying degrees of proteinuria. Routine doses of NSAIDs brought no additional benefit to the ACE inhibitor use in terms of proteinuria and renal functions. The use of selective COX-2 inhibitors should be limited to their anti-inflammatory and analgesic effects in this population.


Clinical Trial. Journal Article.

<26>


16375651

Status

MEDLINE

Authors

Porta C.


Porta, Camillo.

Institution

Medical Oncology and Laboratory of Preclinical Oncology and Developmental Therapeutics,

IRCCS San Matteo University Hospital, Piazzale Camillo Golgi, 2I-27100 Pavia, Italy. c.porta@smatteo.pv.it

Title

Maintenance biotherapy with interleukin-2 and interferon for metastatic renal cell cancer.


Source

Expert Review of Anticancer Therapy. 6(1):141-52, 2006 Jan.

Abstract

The term maintenance immunotherapy comprises at least two different therapeutic approaches: the continuation of immunotherapy beyond disease progression and the use of chronic immunotherapy after the achievement of an initial response (or disease stabilization) with more intensive treatment modalities, such as chemotherapy. The former therapeutic approach was proposed in renal cell carcinoma some years ago relying on several immunological considerations. Some years later, we have learned that it is feasible and endowed with a favorable therapeutic index; furthermore, its immunologic effects are well described and reproducible, and it has antitumor activity. However, due to the lack of adequate randomized Phase III studies, the actual impact of this treatment strategy on patient survival has not yet been proved. The rationale of this treatment, its immunological and clinical results, as well as its pitfalls and perspectives, will be presented and discussed in this review. [References: 89]



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