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Biomedical subjects

A Colombo

Publications and source records attributed to A Colombo.

At least 523 records · Page 29Linked to original sources
PubMedDate not supplied

Brain metastases from cervical carcinoma.

Central nervous system (CNS) involvement by cervical carcinoma is uncommon. Out of 1,184 patients registered for invasive cervical carcinoma at our institution between 1982 and 1994, 14 (1.18%) developed brain metastases. Median age at the time of CNS metastasis diagnosis was 52 years. Median interval between diagnosis of cervical cancer and documentation of brain involvement was 18 months. Clinical manifestation included motor weakness, headache, seizures, dizziness and visual disturbances. All lesions (8 multiple, 6 single) were contrast enhanced on computerized tomography scans and were located in the cerebrum (n = 10), in the cerebellum (n = 2), or in both (n = 2). The CNS was the only site of detectable disease in 7 patients with recurrent disease. Eleven patients received only steroids, and 3 patients received radiotherapy. All 14 patients died, and median survival from diagnosis of brain metastases for the entire series was 4 months (range, 1-21). CNS metastases from cervical cancer are rare, and the prognosis for such patients appears poor.

Adenocarcinoma↗
PubMedDate not supplied

Concurrent carboplatin/5FU and radiotherapy compared to radiotherapy alone in locally advanced cervical carcinoma: a case-control study.

AIMS AND BACKGROUND: Despite the introduction of innovative techniques in radiotherapy (RT) delivery, no significant improvement in survival has been achieved in the last decades. Concurrent chemoradiation therapy (CRT) is one of the several avenues being explored to improve the results. METHODS AND STUDY DESIGN: Twenty-eight women with locally advanced squamous cell carcinoma of the uterine cervix were treated with CRT comprising a combination of external and intracavitary RT, along with 3 cycles of 5-fluorouracil (5-FU) and carboplatin. Toxicity, pelvic control rate and disease-free survival achieved in this group of patients were compared in a case-control study with those of a group of 28 patients with similar clinico-pathologic characteristics treated with radical RT alone at our institution. RESULTS: CRT was well tolerated, with 97% of the patients completing the protocol as planned. Acute toxicity, primarily hematologic, was significantly (P = 0.05) higher in the cases than in the controls (25% vs 3%). One treatment-related death occurred in a stage III patient in the CRT group. The median follow-up was 55 months (range, 20-156) in the RT group and 20 months (range, 14-46) in the CRT group. Pelvic control rate, disease-free survival and overall survival were not significantly different in the two groups. Estimated 5-year survival rate was 70% and 66% respectively for the RT and CRT group. CONCLUSIONS: Concomitant carboplatin/5-FU and radiotherapy is a safe and tolerable means of treatment for locally advanced cervical cancer. In our study, however, concurrent CRT did not result in a significant improvement in pelvic control rate or survival compared to standard conventional radiotherapy.

Adult↗
PubMedDate not supplied

Neoadjuvant chemotherapy to radiation and concurrent chemoradiation for locally advanced squamous cell carcinoma of the cervix: a review of the recent literature.

Radiotherapy is the standard treatment for locally advanced cervical cancer; nevertheless it fails to control disease progression within the irradiation fields in more than 40% of cases, particularly in patients with bulky tumor. Distant metastases are not infrequent in more advanced cases. Chemotherapy has been integrated with radiotherapy to improve local control and treat distant subclinical metastases. Schedules of combined treatment more frequently represented by neoadjuvant chemotherapy followed by radiation (NACT) and by concomitant chemotherapy and radiation (CT-RT). A review of the recent literature is presented. The role of NACT is controversial: high response rates are reported but doubtful advantages in terms of survival or local control have been shown. In randomized trials, hydroxyurea concomitant to radiation improves local control and survival, particularly in stage IIIB and IVA. Several randomized trials of concurrent chemoradiation with 5FU, cisplatin and mitomycin C are underway, but few have been published: no significative differences are reported in term of local control or survival. Acute toxicity is higher than in radiation alone, but usually manageable. For the analysis of late morbidity a longer follow-up is required. Large randomized trials of adequate radiotherapy versus concomitant chemoradiation are necessary to refine our understanding of the benefits of this integrated treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Brachytherapy for isolated vaginal recurrences from endometrial carcinoma.

AIMS AND BACKGROUND: Isolated vaginal recurrences of endometrial carcinoma are rare, and prognostic factors that predict treatment outcome are still not well defined. The aim of the present study was to evaluate the results of brachytherapy in isolated vaginal recurrences from endometrial carcinoma. METHODS: Thirty-five patients with isolated vaginal recurrences were treated with brachytherapy with intravaginal ovoids or cylinders that were calculated to deliver 6000 to 7000 cGy at the surface. Patients were assessed for size and location of recurrence at presentation, response and complications from therapy. RESULTS: Treatment was well tolerated by most patients. Grade 2 toxicity occurred in 4 patients (3 cases of partial vaginal stenosis and one proctitis). Complete response to radiation was observed in all patients, and an overall 9 failures were observed (4 local, 4 distant and 1 local plus distant). Twenty patients (57%) were alive without evidence of disease at 3 to 11 years following treatment. Site of vaginal recurrence (upper third versus others) and long (more than 12 months versus less than 12 months) interval from hysterectomy were the only factors significantly related to local failures. CONCLUSIONS: Isolated vaginal recurrences following hysterectomy for endometrial carcinoma can be treated with brachytherapy with a low rate of severe toxicity.

Aged↗
PubMedDate not supplied

Localization of mucinous-like carcinoma associated antigen (MCA) in breast pathology: comparison with carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA).

The topographic distribution of a mucinous-like cancer antigen (MCA) recognized by a monoclonal antibody b-12 (MAb b-12) was assessed in benign (38) and malignant (66) breast tissues. The reactivity of MAb b-12 showed a good selectivity for breast tissues, reacting both with normal tissues and breast cancer. The degree of MCA expression was evaluated in the various groups of breast pathology adopting quantitative criteria of assessment. With the criteria of evaluation adopted, strong staining was observed in 71.4% breast carcinomas. The most positive reaction was demonstrated in mucinous carcinoma. MCA distribution in breast tissue was compared with the distribution of two other antigens, CEA and TPA. Reactivity of MAb b-12 was higher than the reactivity shown by the anti-CEA and anti-TPA antibodies.

Antibodies, Monoclonal↗
PubMedDate not supplied

Serum levels of soluble CD23 in patients with asthma or rhinitis monosensitive to Parietaria. Its relation to total serum IgE levels and eosinophil cationic protein during and out of the pollen season.

The diagnostic value for allergies of the low affinity IgE receptor and its soluble circulating fragment (sCD23) remains unclear. In particular, little is know about seasonal influences on serum sCD23 levels in subjects with pollen allergy. In the present study, to gain insight into pathophysiological role of sCD23, we have analyzed, in blood from patients allergic to Parietaria sCD23, IgE, and eosinophil cationic protein (ECP) serum levels. IgE were assessed as atopy markers and ECP as an inflammation marker. Patients were studied during and out of pollen season, and results were compared to those obtained in nonallergic subjects. The study population included 42 nonsmoking outpatients, living in Palermo (Sicily, Italy) or in other west Sicilian towns, with a clinical diagnosis of seasonal asthma or rhinitis and monopositive skin test to Parietaria pollen. The group of asthmatic subjects consisted of 25 patients who had one or more of the usual asthma symptoms (wheezing, dyspnea, and cough) only during the pollen season. The group of rhinitis patients consisted of 17 patients, who, during pollen season, had the nasal symptoms (nasal blockage, sneezing, nasal itching, and rhinorrhoea) but no signs of asthma. As a control group, we studied 10 nonatopic subjects from laboratory staff. They had no history of seasonal or perennial rhinitis, asthma, or urticaria and had negative skin tests to a panel of allergens. Soluble CD23, IgE, and ECP were assessed in blood during and out of pollen season. Total serum IgE levels were clearly higher in atopic patients, as classically established. Concerning sCD23 serum levels, a similar pattern of results was obtained. Accordingly, significant correlations were shown between the levels of sCD23 and IgE in all groups of patients. A completely different pattern was observed by analyzing serum ECP levels because ECP levels were significantly increased only in asthmatic patients during pollen season. Accordingly, no significant correlations were observed between the levels of sCD23 and those of ECP. Identifying immune factors associated with the development of atopy can enhance our understanding of the in vivo mechanisms involved and may have utility in paradigms designed to prevent diseases. As demonstrated by the close correlation with total serum IgE values and the lack of correlation with serum ECP values, serum levels of sCD23 appear to be an additional marker for the diagnosis of atopy but not for the follow-up of allergic diseases.

Adolescent↗
PubMedDate not supplied

Effect of hyperthermia on rhodamine 123 cytotoxicity in doxorubicin-sensitive and doxorubicin-resistant human breast carcinoma cell lines in vitro.

Rhodamine 123 (Rh123) cytotoxicity and intracellular accumulation were studied in normothermic and hyperthermic conditions in a human breast carcinoma cell line (MCF7/WT) and its doxorubicin-resistant subline (MCF7/DoxR). MCF7/DoxR cells were resistant to hyperthermia and Rh123. Hyperthermic potentiation of Rh123 cytotoxicity was present in MCF7/WT but not in MCF7/DoxR cells. Results suggest that the effect observed in MCF7/WT cells is related to a heat-induced increased accumulation of Rh123 and not to a heat-induced activation of the drug. A low basal uptake and a fast release of Rh123 could explain the resistance of MCF7/DoxR to the drug. Resistance to Rh123 and lack of a heat-induced increased uptake account for the lack of hyperthermic enhancement of Rh123 cytotoxicity in the resistant cells.

Biological Transport, Active↗
PubMedDate not supplied

Restenosis rate after percutaneous transluminal coronary angioplasty: a literature overview.

In order to elucidate factors affecting the rate of angioplasty restenosis, we reviewed 212 published reports on restenosis after percutaneous transluminal coronary angioplasty. We used five specific methodologic standards to select the 31 reports most likely to produce unbiased results. Sixty one factors judged to be related to restenosis rate were investigated. Only shorter duration of data collection (p=0.0003) was related to higher restenosis rate. This factor may be related to inexperience in choosing subjects or performing procedures. Other factors whose association with restenosis rate did not reach our predetermined level of statistical significance (p less than .01) were angioplasties of the left circumflex artery (p=.02), angioplasty of total occlusions (p=.02) and advanced age (p=.05). The association of shorter data collection with higher restenosis rates suggests that improved outcome may result from consolidation to a few centers specializing in this technique.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

[Urinary cotinine as indicator of exposure to passive smoking].

We studied the association between self-reported exposure to passive smoking (ETS) and urinary cotinine among 95 ex-smokers, who had quit in the context of a smoking cessation trial in general practice, and among 33 ex-smokers who had been contacted in the context of a study aimed at estimating the spontaneous cessation rate among smokers, listed in the roosters of the General Practitioners participating in the trial, who had not been offered recruitment. The results of multivariate linear regression analysis indicated that duration of exposure at home was strongly related to cotinine levels (increase of 1 ng/mg every 3 hours of exposure at home), quantified by radioimmunoassay. Duration of exposure in public places showed a similar effect, but the association was significant only among subjects who reported having been exposed in a heavily ETS polluted environment (increase of 1 ng/mg every 45 minutes of exposure). Among subjects exposed at work cotinine concentration was associated to subjects' judgement of the concentration of ETS, rather than to duration of exposure. Standardized questionnaires may provide a reasonably accurate description of ETS exposure and they can be used to assess exposure in etiologic studies. Non-smokers non exposed to ETS at home may not represent an appropriate control group in such studies. Indeed, they may be exposed to other sources, as indicated by the relatively high levels of urinary cotinine among ex-smokers non exposed at home in our study. Misclassification of these subjects may result in a dilution of the effect of the exposure.

Biomarkers↗
PubMedDate not supplied

Asphyxiating thoracic dysplasia in a lethal form: radiological and sonographic findings.

The authors report a case of a lethal form of asphyxiating thoracic dysplasia (Jeune syndrome) in a newborn female with a narrow thoracic cage causing severe respiratory failure at birth. The diagnosis was unequivocally confirmed by radiographs of thorax and pelvis. This report emphasizes the importance of the radiological and sonographic features in establishing a correct diagnosis.

Asphyxia Neonatorum↗
PubMedDate not supplied

Tc45, a dimorphic Trypanosoma cruzi immunogen with variable chromosomal localization, is calreticulin.

We demonstrate that Tc45, a polypeptide described as an immunogenetically restricted Trypanosoma cruzi antigen in mice, is calreticulin, a dimorphic molecule encoded by genes with variable chromosomal distribution. Previously we showed that IgG from A.SW (H2s) mice immunized with T. cruzi trypomastigotes or epimastigotes and sera from infected humans recognize Tc45, a 45 kD parasite polypeptide. Herein we describe the cloning, sequencing, and expression of the Tc45 gene. A 98% homology in the deduced amino acid sequence was found with a T. cruzi calreticulin-like molecule and 41% with Leishmania donovani and human calreticulin. In the T. cruzi CL Brener clone and in the Tulahuén strain, the gene is located in two and four chromosomes, respectively. Calreticulin was detected in several T. cruzi clones, in the Tulahuén strain, and in T. rangeli, displaying alternative 43 and 46 kD forms.

Amino Acid Sequence↗
PubMedDate not supplied

Matched comparison of slotted tubular and coil stents: differences in acute gain, loss index, and clinical outcome.

Different stent designs may produce differences in immediate and long-term outcome. The objective of this study was to compare the immediate results and long-term outcomes of patients with lesions undergoing implantation of a single slotted tubular stent (Palmaz-Schatz) or a single coil stent (Gianturco-Roubin I). For this purpose, the authors studied patients matched for lesion length and vessel size. The consisted of 135 patients (141 lesions), and the Gianturco-Roubin group was composed of 50 patients (56 lesions). The coil stent was more often used for bailout indications. Larger immediate lumen gain was achieved with the slotted tubular stent. At follow-up examination, there was no difference in stent thrombosis; however, there was a trend toward lower angiographic restenosis and target-lesion revascularization in the Palmaz-Schatz group. Randomized trials using larger numbers of patients are needed to determine differences in outcome among different stent designs.

Aged↗
PubMedDate not supplied

[Chromo-colposcopic images during oral contraception].

The Authors report chromocolposcopic pictures with AZEA (Azure 2 + alcohol-soluble eosine + ethanol) and related histologic pictures in six women under oral contraception. Columnar epithelium develops violet or blue-violet areas histologically corresponding to endocervicitis. Aceto-white epithelium develops reddish color in case of medium-mature metaplasia, brown-violet in case of mature metaplasia, lilac in case of superficial koilocytosis on metaplasia. Native epithelium appears dark brown, or yellow-brown in case of koilocytosis.

Adult↗
PubMedDate not supplied

[Changes in the plasma amino acid profile in critically ill patients during total parenteral therapy].

The aim of this study was to evaluate the kinetics of arterial plasma amino acid profile during the first 48 h of clinical TPN in order to assess the time necessary to reach the steady-state condition during infusion. Each patient was treated with one of three different amino acid solutions yielding, in the same nitrogen intake, different intakes of individual amino acids. We found four different kinetics for the administered amino acids: an increase of plasma levels immediately after the start of the TPN with no variations during the steady period; the same trend with the steady-state obtained after 6-24 h of TPN infusion; no influence at all; a decrease of fasting plasma levels with the steady-state attained variably during the study period. Each given amino acid showed a different trend partly depending on the supply, suggesting that the steady-state was reached sooner for most amino acids, when the supply was larger. With lower intakes, plasma levels were unaffected or decreased. We conclude that in critically ill patients at least 24 h are needed to obtain stable arterial plasma amino acid concentration during TPN with adequate intakes of amino acid. Knowledge offers the possibility for a quick and accurate assessment of the adequacy of a given preparation (tailored for critically ill patients), it reduces the time span of the study and, as a consequence, the influence of varied metabolic conditions.

Adolescent↗
PubMedDate not supplied

[Relation between laboratory tests and densitometry values: characterization of the baseline profile in a perimenopausal population at anamnestic risk for osteoporosis].

The relationship between usual laboratory indexes of bone metabolism and dual photon densitometry in perimenopausal women at anamnestic risk for osteoporosis are studied. One hundred and twenty five women, with one or more risk factors for osteoporosis, have been investigated by: plasma calcium, phosphorus, osteocalcin, ALP-bone-isoenzyme, PTH, and 24 hours urinary calcium and hydroxyproline, besides dual photon densitometry of lumbar spine. Laboratory indexes are indicated as "above normal values" and, within the range of normality, "at lower limits", "average values", and "at upper limits". More than 90% of patients show laboratory findings at the upper limits. Furthermore, 46% of them show both hydroxyproline greater than 20 mg/24 h and urinary calcium greater than 200 mg/24 h; 81.7% osteocalcin greater than 7.00 ng/ml and plasma calcium greater than 4.9 mEq/l; 87.9% osteocalcin greater than 7.00 ng/ml and urinary calcium greater than 200 mg/244; 86.4% densitometric values less than 0.700 g/cm2 and osteocalcin greater than 7.00 ng/ml. Our at risk population shows a wide agreement among the laboratory indexes, to indicate an increased bone metabolism.

Absorptiometry, Photon↗
PubMedDate not supplied

[Climacteric syndrome: comparison of several secondary therapies].

During a first one year period a random treatment for climacteric symptoms with "Estriol vaginal cream" vs "Trazodone and Estriol vaginal cream" and, after it and only in patients not complaining of dyspareunia, with "Trazodone" vs "Veralipride" has been conducted. After the first year all women complaining of dyspareunia were treated with Estriol vaginal cream. Eighty women were enrolled in the five treatment groups. After three months of treatment, a good remission of symptoms was shown, with differences in relations to treatment schedules. Dyspareunia subsided for more than 70% in women treated with Estriol vaginal cream (either by itself or in association), and Estriol vaginal cream achieved the best response from the highest number of the considered symptoms, besides being the only active treatment in insomnia. A good answer on hot flushes and "irritability, anxiety, depression" was obtained by Trazodone, while Veralipride showed to be more active on all neurovegetative symptoms (hot flushes, sweatings, tinglings, palpitations, astenia).

Adult↗