Neoplasms

All Conditions

Rare Diseases

Pheochromocytoma

Paraganglioma

Neuroendocrine Tumors

Neuroectodermal Tumors

Neuroectodermal Tumors, Primitive

Neoplasms, Germ Cell and Embryonal

Neoplasms by Histologic Type

Neoplasms, Nerve Tissue

Paragangliomas 1

Neuroendocrine Tumor

Neuroepithelioma

Analgesics

Central Nervous System Depressants

All Drugs and Chemicals

Antihypertensive Agents

Nitric Oxide Donors

Vasodilator Agents

Dexmedetomidine

Nitroprusside

Hypnotics and Sedatives

Analgesics, Non-Narcotic

Adrenergic Agents

Adrenergic alpha-Agonists

Adrenergic Agonists

Neurotransmitter Agents

Not receive perioperative additional medication.

Received oral 300 mg magnesium one week before surgery and magnesium-dexmedetomidine combination perioperatively.

Received oral 300 mg magnesium one week before surgery and magnesium-dexmedetomidine combination perioperatively

Magnesium-Dexmedetomidine

Nükhet Sivrikoz, MD

Anesthesia management of pheochromocytoma excision surgery is associated with severe hemodynamic fluctuations.The objective of this study was to compare the hypertensive episodes requiring sodium nitroprusside administration between the group treated with magnesium-dexmedetomidine and conventional group in pheochromocytoma.

Magnesium and Dexmedetomidine in Pheochromocytoma

Magnesium and Dexmedetomidine Combination Reduces Sodium Nitroprusside Requirement in Laparoscopic Pheochromocytoma

intraoperative hypertensive episodes requiring SNP therapy

hemodynamic fluctuations (hypotension, tachycardia, severe hypertensive crisis) which needed vasoactive therapy.

Istanbul University

Attending Anesthesiologist

Heart and Blood Diseases

Hypertension

Vascular Diseases

Antineoplastic Agents

Respiratory System Agents

Bevacizumab

Acetylcholine

Antineoplastic Agents, Immunological

Angiogenesis Inhibitors

Growth Inhibitors

Nitric Oxide

Cholinergic Agents

Intra-arterial infusion of acetylcholine in two increasing dosages during 5 minutes each during the intra-arterial infusion of bevacizumab

Infusion of two increasing dosages of nitroprusside during 5 minutes each during the continuous infusion of bevacizumab

The introduction of angiogenesis inhibitors has remarkably improved treatment of patients with several types of cancer. One of the most reported side effects of angiogenesis inhibitors is hypertension. In patients treated with bevacizumab, a monoclonal antibody against vascular endothelial growth factor, hypertension had an overall incidence up to 32%. The increase in blood pressure occurs early in treatment. The etiology of hypertension caused by treatment with angiogenesis inhibitors is unclear. Understanding the pathogenesis of this side effect is essential for optimal treatment with this class of drugs.

The primary objective is to explore the effect of bevacizumab infusion on endothelium-dependent vasodilation of forearm resistance arteries.

Bevacizumab and Endothelium Dependent Vasodilation

Response to infusion of bevacizumab and/or acetylcholin or nitroprusside

Dutch Cancer Society

Radboud University Medical Center

Prof dr. G. Rongen

Skin and Connective Tissue Diseases

Leiomyoma

Myofibroma

Neoplasms, Connective and Soft Tissue

Neoplasms, Connective Tissue

Connective Tissue Diseases

Vasoconstrictor Agents

Cardiotonic Agents

Central Nervous System Stimulants

Norepinephrine

Oxymetazoline

Phenylephrine

Mydriatics

Sympathomimetics

Ephedrine

Pseudoephedrine

Nasal Decongestants

Protective Agents

* Brachial artery catheter
* Acetylcholine
* Nitroprusside
* Norepinephrine
* Nitroprusside and phenylephrine

A catheter will be placed in the brachial artery by a physician on the study day.

Brachial artery catheter

Acetylcholine will be infused into the brachial catheter while blood flow levels in the forearm are measured. Acetylcholine will be infused at the following doses: 1.0, 2.0, 4.0, and 8.0 ug/100 ml tissue/min for 2 minutes each.

Nitroprusside will be infused into the brachial catheter while blood flow levels in the forearm are measured. Nitroprusside will be infused at the following doses: 0.25, 0.5, 1.0, and 2.0 ug/100 ml tissue/min for 2 minutes each.

Norepinephrine will be infused into the brachial catheter while blood flow levels in the forearm are measured. Norepinephrine will be infused at the following doses: 1.0, 2.0, 4.0, and 8.0 ug/100 ml tissue/min for 2 minutes each.

A single dose of nitroprusside (100 ug) will be infused through an IV; one minute later, a single dose of phenylephrine (150 ug) will be infused.

Nitroprusside and phenylephrine

Michael J Joyner, M.D.

The purpose of this study is to learn how uterine fibroids may be connected to heart disease and high blood pressure. It is not known what causes fibroids, but they frequently occur in women who also have high blood pressure, heart disease, and stroke. The investigators of this study want to learn if certain changes in the blood vessels or nerve activity can put women at risk for these diseases and for fibroids.

The investigators are inviting women, 25-50 years old, who have not gone through menopause to participate in this study. The investigators are looking for some women with uterine fibroids and some without uterine fibroids based on ultrasound or MRI. If the patients have not had a recent ultrasound or MRI of the uterus, a physician can provide one.

Individuals cannot participate if they have high blood pressure, diabetes, or disease in the kidneys, lungs, or blood vessels. Also, individuals who smoke, have high cholesterol, or are obese (BMI is higher than 30) cannot participate. Certain medications, including high blood pressure medications, beta-blockers and anti-depressants, will also limit potential patient participation. The investigators would be happy to review medications for potential participants.

Screen Day:

One of the members of the research team will review the study and the informed consent document with the patient. The patient will have their height, weight, blood pressure, pulse and respirations measured. The patient will also complete three questionnaires. If the patient has not had an ultrasound of the uterus in the last 12 months, a physician will complete one for her.

Study Day:

The patient will need to fast overnight (no eating or drinking). The investigators will draw a blood sample and then do a series of tests on the participant's blood vessels. For some of the tests, medication will be given through an IV. The investigators will also test nerve activity in the nerve on the outer aspect of the leg.

Whole blood and serum

No DNA extraction from samples is planned.

Vascular Function and Uterine Fibroids

Sympathetic Nerve Activity and Vascular Function in Women With Uterine Leiomyomata

Blood samples will be collected to measure levels of estrogen and progesterone.

Nerve "burst" activity will be measured across 10 minutes.

An infusion of nitroprusside will be given, followed by an infusion of phenylephrine one minute later.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Magnesium and Dexmedetomidine in Pheochromocytoma	NCT05102058	Phaeochromocyto... Hemodynamic Ins...	Magnesium-Dexme...	18 Years - 75 Years	Istanbul University
Bevacizumab and Endothelium Dependent Vasodilation	NCT01125943	Hypertension Cancer Endothelial Dys...	Acetylcholine Nitroprusside Bevacizumab	18 Years - 50 Years	Radboud University Medical Center
Bevacizumab and Endothelium Dependent Vasodilation	NCT01125943	Hypertension Cancer Endothelial Dys...	Acetylcholine Nitroprusside Bevacizumab	18 Years - 50 Years	Radboud University Medical Center
Vascular Function and Uterine Fibroids	NCT02123069	Leiomyoma	Brachial artery... Acetylcholine Nitroprusside Norepinephrine Nitroprusside a...	25 Years - 50 Years	Mayo Clinic
Magnesium and Dexmedetomidine in Pheochromocytoma	NCT05102058	Phaeochromocyto... Hemodynamic Ins...	Magnesium-Dexme...	18 Years - 75 Years	Istanbul University

Spots Global Cancer Trial Database for nitroprusside