Cardiovascular toxicology
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Cardiovascular toxicology · Jan 2007
ReviewAnthracycline cardiotoxicity in long-term survivors of childhood cancer.
Anthracycline chemotherapy is a widely-used and effective treatment for a wide spectrum of childhood cancers. Its use is limited by associated progressive and clinically significant cardiotoxic effects. Onset can be acute, early, or late. ⋯ Dexrazoxane prior to anthracycline chemotherapy has been shown to significantly lower rates of elevated serum cardiac troponin levels, a marker of myocyte injury, indicating a cardioprotective effect. Pilot studies indicate that exercise interventions may also be beneficial in long-term survivors with cardiac damage. Support and study of this population to decrease the morbidity and morality associated with anthracycline-induced cardiotoxicity is indicated in a time sensitive fashion.
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Cardiovascular toxicology · Jan 2007
ReviewAnthracycline cardiotoxicity in breast cancer patients: synergism with trastuzumab and taxanes.
Doxorubicin is known to cause cardiomyopathy and congestive heart failure (CHF) upon chronic administration. A major obstacle to doxorubicin-containing multiagent therapies pertains to the possible development of cardiomyopathy and CHF at lower than expected cumulative doses of doxorubicin. For example, the cardiac toxicity of doxorubicin is aggravated by the anti-HER2 antibody Trastuzumab or by the tubulin-active taxane paclitaxel; however, the mechanisms by which Trastuzumab and paclitaxel aggravate doxorubicin-induced cardiotoxicity are mechanistically distinct: Trastuzumab interferes with cardiac-specific survival factors that help the heart to withstand stressor agents like anthracyclines, while paclitaxel acts by stimulating the formation of anthracycline metabolites that play a key role in the mechanism of cardiac failure. Here, we briefly review the molecular mechanisms of the cardiotoxic synergism of Trastuzumab or paclitaxel with doxorubicin, and we attempt to briefly outline how the mechanistic know-how translates into the clinical strategies for improving the safety of anthracycline-based multiagent therapies.
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Availability of camphor containing products in households is not uncommon. In certain parts of the world, camphor is used in medicines intended for enteral intake and also used as a flavoring agent in edibles. Toxicity due to ingestion of camphor has been described and in severe forms it manifests as seizures, apnea, asystole, circulatory collapse and death. ⋯ The changes were transient and resolved in a short time while the patient was on supportive therapy. The medicinal uses of camphor are unsupported by evidence and safer, more effective alternatives exist. Its use in household products and edibles should be discouraged.