Doxorubicin-induced cardiac toxicity

Article Abstract:

Doxorubicin and the closely related daunorubicin, members of the anthracycline family of drugs, are very effective chemotherapeutic agents. Doxorubicin, also known by its brand name Adriamycin, is widely used for hematologic cancers such as leukemia, as well as lung cancer and soft-tissue sarcomas. However, over two decades ago it was recognized that doxorubicin can produce irreversible damage to the heart. Indeed, doxorubicin may be the single most effective agent against breast cancer, but its use in effective adjuvant therapy regimens (following surgery) was delayed by fears of cardiotoxicity. Damage to the heart muscle is related to the cumulative dose of doxorubicin. Fewer than 3 percent of patients will develop heart muscle damage with a total dose of doxorubicin of less than 400 milligrams per square meter of body area. At 700 milligrams per square meter of body area, the probability of cardiomyopathy rises to about 18 percent. In practice, doxorubicin therapy is generally discontinued when a total lifetime dose of 400 to 500 milligram per square meter has been reached. In the March 21, 1991 issue of The New England Journal of Medicine, Lipshultz et al. document the heart damage sustained by subjects treated with doxorubicin for childhood leukemia. The growing heart seems to be especially susceptible to the toxic effects of this drug. This may be due to the way in which the heart deals with free radicals. Unlike the liver or the lungs, the heart seems to have only one metabolic method for disposing of free radicals, the glutathione-glutathione peroxidase pathway. Since this pathway is less active in the young heart, free radicals resulting from doxorubicin may exert a greater toxic effect. However, a recently developed drug may serve to protect the heart from the damage caused by free radicals. Called ICRF-187, this drug is a chelating agent similar in structure to EDTA. This agent chelates, or chemically traps, metal atoms and might therefore be used to trap the iron atoms that cause muscle damage after they are torn from their proper location by the free radicals. If ICRF-187 performs as hoped, it may be possible to use doxorubicin with greater therapeutic effectiveness and with a greater degree of safety. (Consumer Summary produced by Reliance Medical Information, Inc.)

Heart, Chelating agents, Anthracyclines, Free radicals (Chemistry), Free radicals, Doxorubicin, editorial

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Cardiac myxomas

Article Abstract:

Cardiac myxomas are benign tumors that often develop in the atria but can be lethal because of their position in the heart. Myxomas can grow into the cardiac chamber, causing obstruction. The obstruction can fill a ventricle, causing shortness of breath, swelling, and heart failure. They are difficult to diagnose because the symptoms are like other cardiac diseases. Two-dimensional echocardiography can be used to find out the size, shape, and point of attachment. CT and MRI can also be used for more specific compositional information on tumors that are at least .5 to 1 cm in diameter. Cardiac myxomas can occur in families in connection with other tumors and syndromes. Prompt surgical removal is generally done and most of the time, will cure the condition. Myxomas can reoccur from incomplete removal of the tumor.

Care and treatment, Diagnosis, Heart diseases, Myxoma, Cardiovascular tumors, Vascular tissue tumors

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Absence of toxicity of oats in patients with dermatitis herpetiformis

Article Abstract:

Oats may be a safe and non-toxic grain for patients with dermatitis herpetiforms. This skin disease is caused by sensitivity to gluten, which is present in wheat, rye and barley. The disease can also affect the intestines. Seven patients with dermatitis herpetiformis added oats to their gluten-free diet for 12 weeks. No patient had an adverse reaction to the oats and did not produce antibodies to gluten on this diet. Biopsies of their intestinal lining showed a normal appearance and there was no significant increase in gluten antibodies in skin samples.

Cooking, Celiac disease, Diet therapy, Oats, Cookery (Oats), Dermatitis herpetiformis

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