Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jun 2005
Case Reports[Cannabinoid hyperemesis with the unusual symptom of compulsive bathing].
Examination of a 36-year-old man revealed no physical or psychological disorders that could explain his chronic, intermittent severe vomiting that did not respond to a wide range of antiemetics. After a recent publication on cannabinoid hyperemesis, the patient was questioned further, and it was found that he was a chronic cannabis smoker since the age of 14 years. This is the first Dutch patient with cannabinoid hyperemesis. ⋯ Due to the severity of the vomiting, patients are frequently hospitalised for the treatment of dehydration. A typical sign ofcannabinoid hyperemesis is compulsive bathing in warm water, which is the only way to suppress the symptoms. The mechanism underlying the syndrome has not been clarified, but it is clear that chronic cannabis use is a key factor: discontinuation causes the symptoms to disappear immediately, whereas recommencing the use of cannabis can lead to the recurrence of cyclic vomiting and nausea within a few weeks or months.
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Ned Tijdschr Geneeskd · Jun 2005
[Favourable result for temozolomide in recurrent high-grade glioma].
To describe the results of the treatment of recurrent glioma with temozolomide. ⋯ 15 patients received temozolomide for a recurrent anaplastic oligodendroglioma or mixed oligo-astrocytoma. The response in this group was 80% and after 12 months in 47% of the patients there was no disease progression. 35 patients underwent second-line chemotherapy with temozolomide after earlier chemotherapy with procarbazine, lomustine and vincristine for recurrent anaplastic oligodendroglioma or mixed oligo-astrocytoma. Response was 26% and after 12 months in 15% of patients there was still no disease progression. 14 patients were treated with temozolomide for a recurrent anaplastic astrocytoma with a response of 35% and after 12 months in 8% of these patients there was no disease progression. Of the 13 patients with a recurrent glioblastoma who were treated with temozolomide 16% responded and after 6 and 12 months 21% were still free from progression. Temozolomide was well-tolerated: 2 patients had to stop because of probable side effects. CONCLUSION. Temozolomide has an acceptable safety profile and may be regarded as the preferred treatment for recurrent anaplastic gliomas after radiotherapy. There is only a limited role for temozolomide in the treatment of recurrent glioblastoma.
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Ned Tijdschr Geneeskd · Jun 2005
Comment[Temozolomide in patients with a glioblastoma multiforme: new developments].
There are new scientific data concerning the treatment of patients with glioblastoma multiforme with concomitant and adjuvant temozolomide following surgery and radiotherapy. Patients have an improved survival rate, especially if they also have a methylated promoter of the methylguanine-DNA-methyltransferase (MGMT) gene. It is advisable to consider treating young patients with primary glioblastoma multiforme who are in good condition with concomitant and adjuvant temozolomide. Efficacy of temozolomide in recurrent glioblastoma multiforme is limited.