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Biomedical subjects

A Costa

Publications and source records attributed to A Costa.

At least 541 records · Page 30Linked to original sources
PubMedDate not supplied

Quality control for biomarker determination in oncology: the experience of the Italian Network for Quality Assessment of Tumor Biomarkers (INQAT).

Biomarker analysis and evaluation in oncology is the product of a number of processes (including managerial, technical and interpretation steps) which need to be monitored and controlled to prevent and correct errors and guarantee a satisfactory level of quality. Several biomarkers have recently moved to clinical validation studies and successively to clinical practice without any definition of standard procedures and/or quality control (QC) schemes necessary to guarantee the reproducibility of the laboratory information. In Italy several national scientific societies and single researchers have activated -- often on a pilot level -- specific external quality assessment protocols, thereby potentially jeopardizing the clinical reality even further. In view of the seriousness of the problem, in 1998 the Italian Ministry of Health sponsored a National Survey Project to coordinate and standardize the procedures and to develop QC programs for the analysis of cancer biomarkers of potential clinical relevance. Twelve QC programs focused on biomarkers and concerning morphological, immunohistochemical, biochemical, molecular, and immunoenzymatic assays were coordinated and implemented. Specifically, external QC programs for the analytical phase of immunohistochemical p53, Bcl-2, c-erb-2/neu/HER2, and microvessel density determination, of morphological evaluation of tumor differentiation grade, and of molecular p53 analysis were activated for the first time within the project. Several hundreds of Italian laboratories took part in these QC programs, the results of which are available on the web site of the Network (www.cqlaboncologico.it). Financial support from the Italian Government and the National Research Council (CNR) will guarantee the pursuit of activities that will be extended to new biomarkers, to preanalytical phases of the assays, and to revision of the criteria of clinical usefulness for evaluating the cost/benefit ratio.

Autoradiography↗
PubMedDate not supplied

Autoimmune cholangitis: case report.

We report on 2 patients who showed mixed signs of primary biliary cirrhosis and autoimmune hepatitis. Both patients were female, in their fifties (54 and 58), their laboratory tests indicated cholestasis, and a liver biopsy revealed liver cirrhosis with significant lesions of the bile ducts. Both were treated with prednisolone with their liver tests showing a rapid normalization of their aminotransferases. These patients can be considered as presenting with what is known as the overlap syndrome or autoimmune cholangitis, which has the clinical, biochemical, immunological, and histopathological characteristics of primary biliary cirrhosis and autoimmune hepatitis type I.

Biopsy↗
PubMedDate not supplied

Migraine as a complex disease: heterogeneity, comorbidity and genotype-phenotype interactions.

Migraine is a chronic illness interspersed with acute signs and symptoms which is currently defined, according to IHS criteria, in terms of "attacks". However, this should not lead us to ignore a critical point emerging from the simple observation of patients, i.e. the variability of the combinations in which the disease manifests itself in the same individual and especially in different individuals. This heterogeneity underpins both migraine "as attacks" (e.g. presence/absence of aura, different pain severity) and migraine "as a disease" (e.g. different onset, occurrence, association with other diseases, evolution, outcome). Genetic determinants are certainly at the basis of some migraine forms, and the role of genetics is now increasing due to the better phenotypical characterization rendered possible by the 1988 criteria. In most cases, however, migraine occurs as multifactorial inherited character. The level of complexity is further increased by the effect of "modifying" genes (such as those encoding for dopamine receptors), by comorbidity (the non coincidental association with other neurological diseases), and by the fact that the expression of comorbidity varies over time (phenotypical heterochronia). The clinical-descriptive approach allows only a partial understanding of migraine, the nature of which is more complex and heterogeneous than previously thought.

Adult↗
PubMedDate not supplied

[Autoimmune cholangiopathy].

We report two patients with mixed characteristics of primary biliary cirrhosis and autoimmune hepatitis. They are two female patients in their fifties (54 and 58 years-old) one of them with autoimmune phenomenon, rheumatoid arthritis and Sjögren syndrome. Both of them showed laboratory values of cholestasis and the liver biopsy revealed liver cirrhosis with significant lesions of the bile ducts. They were treated with prednisolone with a rapid improvement and normalisation of their blood tests. They belong to a group called as overlap syndrome or autoimmune cholangitis with mixed characteristics, clinical, biochemical, immunological, and histopathologic overlapping between primary biliary cirrhosis and autoimmune hepatitis type I.

Autoimmune Diseases↗
PubMedDate not supplied

[Cerebral hematoma caused by mucormycosis].

INTRODUCTION: Invasion of the central nervous system by mucormycosis is rare. It is mainly seen in diabetic ketoacidosis, immunosensitive or severely debilitated patients and in cases of hematological neoplasias. We describe a case of cerebral hemorrhage with documented evidence of invasion of the cerebral vessels by mucormycosis, in a patient with a gastric adenocarcinoma. CLINICAL CASE: A 38 year old woman complained of the sudden onset of headache and disorder of vision which progressed rapidly to coma. Computerized tomography showed the presence of a parieto occipital hematoma. The patient died six hours later. She had had an operation for gastric carcinoma eight months previously. Anatomopathological study of the brain showed invasion of the arterial wall by mucormycosis. CONCLUSION: Solid tumors may lead to cerebral hemorrhage caused by mucormycosis.

Adenocarcinoma↗
PubMedDate not supplied

Circadian rhythms in blood, urine and gastric acid secretion of presumably healthy volunteers.

The mean conisor technique reveals statistically significant circadian rhythms for serum concentrations of iron, chloride, cortisol, PBI, the fibrinolytic activity of blood, urinary iron excretion and gastric acid secretion in studies covering a 24-h span for presumably healthy subjects. Quantification of these rhythms provides internationally comparable reference values both for the conventional clinical laboratory and for any special chronobiologic applications.

Adolescent↗
PubMedDate not supplied

Temozolomide in radio-chemotherapy combined treatment for newly-diagnosed glioblastoma multiforme: phase II clinical trial.

BACKGROUND: Continuous research into new strategies and chemotherapy agents for the treatment of malignant high-grade gliomas have led to the synthesis of a new chemotherapy drug, temozolomide (TMZ), with a lower toxicity profile compared to conventional chemotherapy agents, such as nitrosoureas. Temozolomide is an oral alkylating chemotherapy agent licensed for the treatment of recurrent high-grade gliomas, anaplastic astrocytoma (AA) and glioblastoma multiforme (GBM). Because of its favorable pharmacokinetic and pharmacodynamic properties and improved tolerability, TMZ is now under investigation for concomitant use with radiotherapy in patients with newly-diagnosed GBM. We present a phase II clinical trial investigating the efficacy and safety of radio-chemotherapy combined treatment using TMZ, followed by six cycles of adjuvant chemotherapy with TMZ, in patients with newly-diagnosed GBM who have undergone debulking surgery or biopsy only. PATIENTS AND METHODS: Twenty-one patients with newly histologically-diagnosed GBM were enrolled into this phase II clinical trial. In phase I of the study, TMZ (75 mg/m2/day per 7 days/wk for 6 weeks) was orally administered to patients concomitantly with radiotherapy (RT) (2 Gy per fraction once daily, per 5 days/wk for 6 weeks). In phase II of the study, four weeks after completion of RT, a monochemotherapy using TMZ was administered at the dosage of 200 mg/m2/day per 5 days every 28 days for 6 cycles. Primary end-points were the safety and tolerability profile of this two-phase combined treatment and secondary end-points were the objective response and survival rates at twelve months and eighteen months from study entry. RESULTS: The one-year survival rate of patients treated with the investigated multimodality treatment was 58% and median survival time was 15.7 months. Concomitant RT plus TMZ (phase I) followed by adjuvant TMZ (phase 2) were well-tolerated; indeed, nonhematological adverse events were rare and mild to moderate in severity; grade 3 and 4 neutropenia and thrombocytopenia were the major-related hematological side-effects observed in only 2 and 3 of all patients in phase I and 4 patients in phase II. We found that the combination of radio- and chemo-therapy, in phase I of the study did not significantly increase the incidence and severity of hematological toxicity caused by the adjuvant TMZ-based chemotherapy administered in phase II of the study. CONCLUSION: The investigated multimodality treatment regimen was well-tolerated and prolonged survival while improving patients' quality of life.

Adult↗
PubMedDate not supplied

[Reduction of the incidence of nosocomial infections after assessing and revising the quality of assistance in a thoracic surgery unit].

An active surveillance for nosocomial infections has been lead in a Thoracic Surgery with the intention, first to point out their frequency and characteristics, and then to outline all the measures to remove the main risk factors checking the results obtained. A prospective incidence study has been promoted in a Thoracic Surgery in the years 2000, 2001, 2002. The analysis has been lead weekly gathering all necessary data from the health records and making laboratory tests to look for microbes growth in the air of Thoracic Surgery Operating Rooms. A nosocomial infections incidence of 13.3% among surgically treated patients has been registered in 2000. Deep surgical site infections were the most frequent localizations, and microbes isolated were Staphylococcus aureus and coagulase negative Staphylococcus with an high oxacillin resistance (70.6%-76.5%). From the observation of the risk factors the sterilization system has been modified and the assistance and environmental protocols have been improved. In the further evaluation period, a global reduction of nosocomial infections incidence (7.1%), of surgical site infections (from 10.1% to 4.5%) (p = 0.007), of Staphylococcus aureus and coagulase negative Staphylococcus isolations have been obtained even if short results in antibiotic resistances have been registered. Thoracic Surgery has to be considered an area at medium-high risk of nosocomial infections. The quite high incidence of nosocomial infections recorded at the beginning of the study in presence of prevalent deep surgical site infections from staphylococci with an high oxacillin resistance compelled to promote corrections. These lead to a remarkable decrease in incidence of nosocomial infections even if the same results can not be reached in antibiotic resistances.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Evaluation of radiation doses during radiological tests].

The purpose of this document is to provide radiologists with a simple, but realistic means of determining the individual dose delivered to a patient during a radiological examination both in the region under investigation and at any other particularly sensitive organs. Fourteen types of examinations were considered corresponding to those most frequently carried out in France. The choice of examinations and methods of taking the films approaches as closely as possible, the average situations, and the frequency of different techniques is influenced by the results of a national study of radiodiagnostic examinations carried out in France in 1982. In the first section, the influence on the radiation dose of varying different physical parameters and techniques is analysed, with an aim of defining the limits of validity of the presented dosimetric values and the possible adaptation of these values to any individual situation, which is slightly different from these considered in this study. The second section describes the model used for determining the absorbed dose presented in the tables, concerning each type of examination, as well as bibliographic references referring to methods and results of determining the dose. The suggested calculation model may be used as a base for dose estimation for other types of examination.

Abdomen↗
PubMedDate not supplied

[Uterine, adnexal and cul-de-sac masses. Comparative study by intravaginal and trans-abdominal echography].

42 female patients were selected for Trans-Vaginal Sonography (TVS) in an ultrasonographic study, after clinical examination, computed tomography or a previous study had suggested the existence of one or more lumps in the pelvic cavity. The TVS method gave higher quality diagnostic information in 55% of the cases studied, while the Trans-Abdominal method was better in 12.5% of the cases. In 79% of the cases the TVS was considered better in image quality while 11% of the cases showed the same image quality in all of the methods. The results agree with those obtained by other authors and confirm that Trans-Vaginal Sonography is of considerable value in the study of female pelvis, as an isolated exploration, complementary or otherwise with subsequent abdominal examination with or without a full bladder.

Adnexal Diseases↗