tetracycline and Sclerosis

Topics: Adolescent; Adult; Aged; Cholangiography; Cholangitis; Colitis, Ulcerative; Diagnosis, Differential; Drainage; Female; Hepatitis B Antigens; Humans; Liver; Male; Middle Aged; Pancreatitis; Phlebitis; Portal Vein; Sclerosis; Shwartzman Phenomenon; Tetracycline

A dichotomy exists in the literature concerning the efficacy of sclerosing agent tetracycline hydrochloride for treatment of thyroid cysts. However, the studies vary in patient selection and none employed a statistical method for simultaneous analysis of multiple factors that might affect the outcome of therapy. We, therefore, studied the efficacy of percutaneous instillation of tetracycline for eradication of recurrent thyroid cysts, using a multivariate analysis. Thirty-seven patients with recurrent, cytologically benign thyroid cysts (not cured after 3 aspirations) were studied. Twenty-three patients were given tetracycline instillations [100 mg/ml, range (R): 1-4 ml]. The remainder underwent only repeated needle aspiration. They were followed for 33 +/- 12 (SD) months, R: 12-58 months. Cure was achieved in 21 out of 23 cases after tetracycline instillation within 2 +/- 1.7 months (R: 1-6 months) and in 12 out of 14 cases after aspiration alone within 9.9 +/- 11.3 months (R: 1-43 months, 4-10 aspirations). Multivariate survival analysis using the Cox proportional-hazards regression model demonstrated significantly shorter time interval before cure in the group with tetracycline instillation (p = 0.001). The volume, color or duration of cysts and levothyroxine (L-T4) treatment did not appear to influence the outcome of therapy. After initial cure by tetracycline instillation, 5 cases had relapse. Three were later cured by reinstillation of tetracycline or by repeated aspirations (R: 1-3 times). Complications of tetracycline instillation included brief episode of neck pain and development of a foreign body granuloma in a single patient. In conclusion, tetracycline instillation is a quick and effective procedure for treating recurrent thyroid cysts.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Administration, Cutaneous; Adolescent; Adult; Aged; Cysts; Female; Humans; Male; Middle Aged; Multivariate Analysis; Sclerosis; Tetracycline; Thyroid Diseases; Thyroid Gland; Thyroxine

In a prospective study, 53 consecutive patients with solitary thyroid cysts were randomized to ultrasonically guided cyst aspiration and subsequent flushing with isotonic saline (n = 30) or tetracycline hydrochloride (n = 23). The patients were followed up clinically and ultrasonically 1, 3, 6, and 12 months after treatment. If the cyst recurred, a repeated treatment was offered. Cure was defined as the absence of any residual nodule and an ultrasonic cyst volume of less than 1 mL 12 months after the last treatment. During follow-up, two patients without recurrence after saline treatment and six patients without recurrence after tetracycline treatment developed solid cold nodules. Fourteen (47%) of 30 patients in the saline group and ten (43%) of 23 patients in the tetracycline group were cured (not statistically significant). Tetracycline does not seem to offer any advantage over isotonic saline in the treatment of thyroid cysts, and some of these patients still need thyroid surgery.

Topics: Cysts; Female; Follow-Up Studies; Humans; Isotonic Solutions; Male; Random Allocation; Recurrence; Sclerosis; Sodium Chloride; Tetracycline; Thyroid Diseases; Thyroid Gland; Ultrasonography

Twenty-two patients with malignant pericardial effusion were seen at the Toronto General Hospital between 1979 and 1984. Under ECG monitoring, an indwelling Kifa catheter was inserted into the pericardial sac and then connected to a Hemovac system and allowed to drain for 12 to 24 hours. Xylocaine hydrochloride, 100 mg, was first instilled intrapericardially, followed by tetracycline hydrochloride, 500 to 1,000 mg, dissolved in 20 mL normal saline. The catheter was clamped for one to two hours and then allowed to drain into the Hemovac. This procedure was repeated every 24 to 48 hours until the net drainage was less than 25 mL/24 hours. Nine men and 13 women were treated (median age, 55 years). The primary malignancy included lung in 15 patients, breast in two patients, and carcinoma of the stomach, ovary, pleural mesothelioma, chronic granulocytic leukemia, and adenocarcinoma of unknown primary in one patient each. Twenty patients received one to five instillations of tetracycline. In one patient the catheter could not be inserted into the pericardial sac, and in one patient the catheter clotted before tetracycline instillation. Minor complications included transient arrhythmia in two patients, postinjection pain in four patients, and self-limited temperature elevation greater than 38.5 degrees C in two patients. fifteen patients had good control of their malignant pericardial effusion for more than 30 days (median survival, 160 days; range, 38 to 275 days). Three patients died before 30 days without evidence of effusion, and no patient surviving longer than 30 days developed recurrent effusion or pericardial constriction. Intrapericardial tetracycline instillation is a safe and efficacious treatment for malignant pericardial effusion and should be considered the first treatment modality in this situation.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Cardiac Catheterization; Drainage; Echocardiography; Electrocardiography; Female; Heart Neoplasms; Humans; Male; Middle Aged; Neoplasms; Pericardial Effusion; Pericardium; Prognosis; Sclerosis; Tetracycline

Topics: Adult; Aged; Alopecia; Anti-Bacterial Agents; Balanitis; Biopsy; Child; Child, Preschool; Chloramphenicol; Deoxyuridine; Diagnosis, Differential; Diagnostic Errors; Erythromycin; Exanthema; Female; Hemorrhoids; Hernia, Inguinal; Herpes Simplex; Humans; Lymphadenitis; Male; Metronidazole; Middle Aged; Mycoses; Oxytetracycline; Penicillins; Sarcoidosis; Sclerosis; Skin Tests; Stomatitis; Syphilis; Syphilis Serodiagnosis; Syphilis, Latent; Tetracycline

Topics: Adult; Biopsy; Bone Regeneration; Female; Humans; Ilium; Male; Microradiography; Microscopy, Fluorescence; Necrosis; Osteitis; Sclerosis; Spondylitis, Ankylosing; Tetracycline

Topics: Adult; Cholangitis; Humans; Male; Sclerosis; Tetracycline

Topics: Aged; Female; Humans; Infarction; Intestinal Obstruction; Intestine, Small; Jejunum; Kidney; Malabsorption Syndromes; Scleroderma, Systemic; Sclerosis; Tetracycline

Topics: Actinomycosis; Adolescent; Adult; Drug Resistance, Microbial; Female; Fungi; Headache; Humans; In Vitro Techniques; Male; Middle Aged; Nausea; Phlebitis; Sclerosis; Skin Manifestations; Tetracycline; Vomiting