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Biomedical subjects

A Curcio

Publications and source records attributed to A Curcio.

At least 19 recordsLinked to original sources

Field efficacy of minidosed eprinomectin against Hypoderma spp. in dairy cattle.

A chemoprophylactic field trial was conducted to assess the efficacy of pour-on eprinomectin applied at the approximate dose of 50 mcg/kg to dairy cattle with naturally occurring hypodermosis. Two-hundred-eleven cattle, selected from two herds with a high prevalence of Hypoderma spp. infestation, were divided in three groups: Group A (N = 71) was treated with pour-on eprinomectin at the recommended dosage of 500 mcg/kg, Group B (N = 64) at the lower dose of 50 mcg/kg, a third group (Group C, N = 76) served as untreated control group. Treatments were performed in November-December 2002 and the animals were examined for the presence of warbles in the following April and June. No larvae emerged in the treated groups, whereas a variable number of warbles (ranging from 1 to 28) were found in control animals. Adverse reactions were not observed in any animal, and only minor side effects were observed. A larger field trial carried out in the following year (1064 treated and 131 untreated control cattle) confirmed the chemoprophylactic efficacy of minidosed eprinomectin against Hypoderma spp. Administration of eprinomectin minidoses in dairy cattle is interesting because of the low costs involved and no need for milk withdrawal.

Administration, Topical↗

Choledochal semi volvulus with jaundice due to hiatal hernia. Initial percutaneous management.

Large diaphragmatic hernias are rare causes of common bile duct strictures. We report a case of mixed (slide and paraesophageal) hiatal hernia with jaundice due to choledochal dislodgment and torsion. The first time we named this entity choledochal semi volvulus. Its pathophysiology is analyzed and we remark the wise and accurate percutaneous management as diagnostic and initial therapeutic resources.

Cholangiography↗

A new rat model of small vessel stenting.

OBJECTIVES: Restenosis is the major complication of coronary angioplasty and stenting. In addition, the small vessel diameter represents a major limitation to the wide use of the technology. The aim of this study was to assess the feasibility and the vascular response of stent deployment in rat small vessels. METHODS: In 40 Wistar rats (500-550 g) a Nir stent crimped on a 1.5 mm Comet angioplasty balloon catheter was deployed at high pressure in the common carotid artery. Neointimal area, neointima/media ratio and the arterial dimension were assessed immediately and at 7, 14, 21, and 28 days after stenting. RESULTS: After stent deployment, the neointimal area and the neointima/media ratio increased progressively and peaked at 14 days (p < 0.05 vs 0 and 7 days). Alpha-actin-positive cells were found circumferentially organized on the lumen surface. At 21 and 28 days after stenting, the neointima and the neointima/media ratio were not statistically different compared with the results obtained fourteen days after stent deployment. No significant differences in the area of external elastic lamina were observed during the study period. In contrast, the internal lumen area was reduced significantly at 14, 21, and 28 days after the stent deployment. Subacute thrombosis rate after stent implantation was 26.5 %. CONCLUSIONS: The results of this study demonstrated that the balloon expandable stents can be safely placed into rat arteries and the reduction of the internal arterial lumen observed after stent deployment was only due to the neointima formation whereas remodeling did not occur.

Animals↗

["Mechano-" and "chemo-sensitive" esophagus. Investigation of non-cardiac chest pain using intraesophageal balloon test and acid perfusion].

UNLABELLED: Mechano--and chemo--sensitivity were studied in 20 normal control patients and 73 patients suffering from pirosis, chest pain or both symptoms. Upper endoscopy, balloon and acid perfussion tests were performed. Balloon was inflated up to 15 ml. and deflated, in 2 cm. steps from 38 to 22 cm. from S.D.A. The number of patients with response, volume of balloon distension that evoked symptoms, place and irradiation of pain or discomfort were registered and plotted on 13 frontal and 10 dorsal zones. The total number of areas involved in pain irradiation was considered as "number of responses". Nine levels were stimulated. Acid perfusion and clearance tests were performed at the same session. Test positivity was accepted when some test evoked spontaneous patient's symptoms. RESULTS: When 9 levels were stimulated, balloon reproduced symptoms in 77.5%. If only one level was considered, the maximal rate was 51%. There were "silent areas" interposed between "trigger zones". In 66.6%, responses with volumes of + < 7 ml. were obtained. In all patients with chest pain upper endoscopy was normal. In 70% of the total group and in 62.5% of patients with pirosis the acid perfusion test was "positive". Esophagitis increased the probability of a positive test. In sixty per cent, patients with combined pirosis and chest pain responded separately with each test. In 6% acid perfusion evoked pain. In 6.1% balloon evoked pirosis. CONCLUSION: 1) Balloon test could be considered the most useful test in mechano-sensitivity investigation. 2) acid perfussion was useful for chemo-sensitivity investigation. As esophagitis increases chemosensitivity, it could be a conditionant factor in some patients. 3) Patients with combined symptoms responded as a mixed sensorial dysfunction with each test. 4) sub-population of patients had atypical responses to the provocative tests.

Adult↗

[Esophageal sensitivity. Projection of esophageal pain induced by balloon distension].

UNLABELLED: The esophagus is source of several kinds of painful sensibility. Esophageal sensoriality follows the general visceral sensibility laws with some individual differences. We have investigated the areas of pain projection induced by a progressive balloon distension in 2 cm scales from 38 to 22 cm. of the dental row. It was registered the number of painful responses in everyone of the 13 frontal zones an 10 dorsal zones in which the chest was divided. Epigastrium and the base of neck were included. It was considered the first patient's symptom or until a maximum of 15 ml. of air (diameter = 3.2 cm.) 101 patients were examined. 1153 responses in the all 9 stimulated levels were obtained. 93.8% were in frontal zones, and 82.4% of them in median areas (from epigastrium to neck). There were not differences between both sexes. The inferior esophagus was significantly less sensible than the superior esophagus. The number of projections to the superior chest was proportionally larger. There were individual patterns which could be usefull in a particular patient. CONCLUSIONS: a) the esophagus is not equally sensible in its whole extension; b) the metameric projection is multiple and predominates in frontal areas; c) the existence of "trigger zones" obligate to examine the whole extension of the esophagus when intraesophageal distension of a balloon is used as a diagnostic test.

Adult↗

Supersensitivity to vasoconstrictor action of serotonin precedes the development of atheroma-like lesions in the rabbit.

We have studied the relationship between the early morphological changes and arterial responsiveness to vasoactive agents in a new animal model that is proposed to mimic the events of early human atherosclerosis. Atheroma-like lesions were produced by positioning a hollow Silastic collar (referred to as a cuff) around the common carotid arteries of rabbits. Following a period of either 48 h or 1, 2, or 4 weeks after surgery, vessels from both cuffed and sham-operated animals were removed, and vascular reactivity to cumulative concentrations of agonists were studied in isolated rings in organ baths. The contralateral arteries were perfused and fixed, studied by light microscopy, and the degree of intimal thickening was quantified by computer-assisted morphometric analysis and expressed as changes in the ratios of the cross-sectional areas of the intima and media in each artery. At 48 h, rings prepared from cuffed arteries were sixfold more sensitive to the contractile effects of serotonin (5-HT) than the corresponding controls. Histologically, such vessels showed some perivascular inflammation but no other morphological abnormality. At 7 days, cuffed vessels were again sixfold more sensitive to 5-HT than controls, and showed a thickened intima with marked smooth muscle proliferation and some infiltration by monocytes. Intimal/medial cross-sectional area ratios remained elevated at 2 and 4 weeks, but the supersensitivity to 5-HT diminished by 2 weeks to threefold and was absent at 4 weeks. The augmented reactivity to 5-HT at 48 h was specific, in that it did not occur for the alpha-adrenoceptor agonist, phenylephrine.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Yield of total body GA-67 scintigraphy in the staging of non-small cell lung cancer.

One hundred and one patients with histologically proved non-small cell lung cancer underwent whole body gallium-67 (TB Ga-67) scintigraphy as a part of their routine pretreatment evaluation. Twenty-eight of these patients were subsequently operated and pathologically staged for hilar and mediastinal disease. Two other patients underwent mediastinoscopy, but were judged unresectable at that time. All had computed tomography (CT) of the thorax, as well as radionuclide or CT scans of suspicious metastatic areas, and were carefully followed-up. When possible, a biopsy was performed of each suspected metastasis. Primary lung tumors concentrated Ga-67 in 94 patients. Sensitivity, specificity, and accuracy for hilar and mediastinal node metastases were 58%, 89%, and 77%, respectively. There were no false-negative gallium scans as regards secondary involvement of both liver and bone, whereas only 1 of the 4 brain metastases was detected by the technique. Sensitivity, specificity, and accuracy for all metastatic sites were 82%, 38%, and 56%, respectively. Fifty-five patients were classified as having a more advanced stage of disease by TB Ga-67 scintigraphy than at the initial clinical evaluation. However, 42 gallium-staged patients were ultimately re-classified differently according to all available clinical data. Using TB Ga-67 scintigraphy, 21 patients were found to have occult metastases which would not otherwise have been recognized; for the above reason, an unnecessary intervention was avoided in 6 of them.

Adult↗

Continuation of chemotherapy versus supportive care alone in patients with inoperable non-small cell lung cancer and stable disease after two or three cycles of MACC. Results of a randomized prospective study.

Recommendations concerning the continuation of chemotherapy in nonresponding patients with non-small cell lung cancer (NSCLC) and stable disease after the first chemotherapy test are empirical and often conflicting. Between 1984 and 1987, 116 inoperable NSCLC patients were treated with methotrexate, doxorubicin, cyclophosphamide, and lomustine (MACC regimen). After two or three cycles of therapy, 74 patients were judged to have stable disease and assigned at random either to chemotherapy maintenance with the same regimen (38 subjects) or to chemotherapy discontinuation (36 subjects). The two study groups were comparable for all the major prognostic factors. Median time to progression was 26 weeks for the chemotherapy group compared to 24 weeks for the nonchemotherapy group (P = NS). Median survival was prolonged in the treatment arm (47 weeks) compared to nontreatment arm (30 weeks), which was statistically nonsignificant. A patient self-assessment of the quality of life revealed a significantly worse tolerance to therapy and a better physical condition in the chemotherapy group. Objective MACC toxicity was significant with two treatment-related deaths. This study failed to demonstrate sufficient therapeutic benefits to justify the increased cost and toxicity of continuing treatment in nonresponding NSCLC patients.

Adult↗

Combination chemotherapy with methotrexate, adriamycin, cyclophosphamide and CCNU (MACC) for nonsmall cell lung cancer. 4-year experience with 92 patients.

Ninety-two nonsmall cell lung cancer (NSCLC) patients were treated with a combination chemotherapy containing methotrexate, adriamycin, cyclophosphamide and CCNU (MACC). The regimen was administered in the dose and schedule originally reported. Median survival for all patients was 32 weeks. Only 6 patients demonstrated an objective response with a median survival rate of 51 weeks. The remaining 70 evaluable patients were nonresponders. These latter patients had a survival probability reduced to 29 weeks. Median time to progression for the whole group was 17 weeks. Partial responses were seen in 3 squamous, 1 large cell carcinoma and 1 adenocarcinoma. One patient with bronchiolo-alveolar carcinoma had complete disease regression and is still alive 136 weeks after starting treatment. Toxicity was significant with 2 treatment-related deaths. The major toxic effects consisted of myelosuppression, nausea, vomiting, and stomatitis. Alopecia was nearly universal; a mild cardiac, renal, or hepatic toxicity was relatively infrequent. Polychemotherapy with MACC regimen may benefit a few selected patients with NSCLC, but its overall antitumor efficacy appears to be very limited.

Adult↗

Tumor markers in bronchogenic carcinoma. Superiority of tissue polypeptide antigen to carcinoembryonic antigen and carbohydrate antigenic determinant 19-9.

One hundred six patients with histologically proven bronchogenic carcinoma were tested for carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), and carbohydrate antigenic determinant 19-9 (CA19-9). A total of 349 CEAs, 350 TPAs, and 317 CA19-9s were measured. In addition, sera were assayed from 57 patients with pulmonary benign diseases and their CEA, TPA, and CA19-9 levels were used as negative controls for specificity and accuracy. One hundred twenty healthy subjects provided our normal CA19-9 reference value. Sensitivity, specificity, and accuracy were obtained for CEA, TPA, and CA19-9, respectively. Significant intermarker correlations were found both at diagnosis and during follow-up, CEA and CA19-9 being the most closely related substances. The percentage of patients with elevated levels of TPA increased significantly according to tumor load. Individual values of TPA related significantly to the stage of disease. Concentrations of CEA, TPA, and CA19-9 varied significantly during the course of the illness in relation to treatment response; however, TPA showed the closest relationship to the clinical status assessments of the follow-up period. Abnormal pretreatment levels of TPA were significantly associated with a poor outcome. Biomarker combinations were clinically evaluated by calculating the mean of the percentage of the reference value for each combined marker. Using this method, any association of TPA with CEA and/or CA19-9 revealed neither a greater diagnostic accuracy nor a more reliable predictive capacity for the above clinical variables than TPA evaluated on its own. The authors believe that a single TPA assay should be added to the initial and subsequent clinical assessments of patients with bronchogenic carcinoma.

Antigens, Neoplasm↗

Lack of clinical significance of gallium-67 uptake in non-small cell lung cancer.

To evaluate the clinical significance of tumor Ga-67 uptake, we studied 89 consecutive patients with a potentially resectable non-small cell lung cancer (NSCLC) by performing a whole body Ga-67 scan. For each scintigraphy, an overall Ga-67 accumulation index (T-N) and a volume independent index (T/Nr) were calculated. Both parameters were related to disease extent, response to subsequent treatment and host survival. With the exception of the significant correlations of T-N to both stage of disease and survival-the higher the T-N, the more advanced the disease and the worse the prognosis-no other relationship was found. Based on these findings, we conclude that, in NSCLC at least, gallium uptake is mainly dependent on tumor size and, therefore, of limited practical value.

Adult↗

Clinical value of a multiple biomarker assay in patients with bronchogenic carcinoma.

In 98 newly diagnosed patients with histologically proven bronchogenic carcinoma seen at Cuneo Hospital of Chest Diseases from July 1983 to December 1984, multiple biomarker assays were performed. Fiftynine cases had more than one carcinoembryonic antigen (CEA) and/or tissue polypeptide antigen (TPA) assay during the course of the disease, at 3- to 12-week intervals. A total of 209 CEA (91 pretreatment), 170 TPA (80 pretreatment), 62 human chorionic gonadotropin (HCG)-beta subunits and 60 lactate dehydrogenase (LDH) was assayed. In addition, serum samples were taken from 141 blood donors and their TPA values were used as a control. The percentages of elevated values were, respectively, 37%, 52%, 18%, and 25%. In 85% of the patients at least one biomarker was found to be higher than normal. Neither significant differences between mean biomarker levels in tumors of various histologic types nor positive intermarker correlations were found. The number of patients with elevated CEA, TPA, and LDH serum levels and their mean values increased significantly according to the disease extent. Among evaluated markers TPA showed the highest accordance to tumor burden. The raising of two markers was never associated with Stage I-II disease, except in one patient. Both CEA and TPA concentrations changed significantly during the course of the illness in relation to the clinical status assessment. Abnormal pretreatment levels of CEA, LDH, and particularly, TPA were independently and significantly associated with a poor outcome. Patients with abnormal levels of TPA and LDH and, to a lesser degree, TPA and beta-HCG had shorter survival as compared with patients with high TPA values, irrespective of the LDH and beta-HCG levels, although not significantly so.

Adenocarcinoma↗

MACC (methotrexate, doxorubicin, cyclophosphamide and lomustine) versus cis-platinum and etoposide in the treatment of advanced non-small cell lung cancer.

From June, 1982 to December, 1984, 35 consecutive patients with histologically proven non-small cell lung cancer (NSCLC) were treated either with methotrexate, adriamycin, cyclophosphamide and CCNU (MACC regimen) or cis-platinum and etoposide (DDP-VP16). The rates of objective responses were, respectively, 15% (3 partial responses out of 20 patients) and 13 (2 out of 15). Times to progression were significantly prolonged in the DDP-VP16 group (median: 29 weeks vs 11), with a trend to improvement in the median survival time (30 weeks vs. 17, P less than 0.1). Except for life-threatening leukopenia in 15% of the MACC patients and intractable vomiting in 47% of patients on cis-platinum based chemotherapy, no serious toxicity was observed. The DDP-VP16 combination seems to be more effective, but less well tolerated, than the MACC regimen and can be recommended for compliant patients with good prognostic factors.

Adult↗

Aortic valve replacement in the elderly.

With increasing longevity, increasing numbers of patients in their 8th decade present with symptomatic aortic valvular disease. We have examined the results of aortic valve replacement in 30 patients of 70 years or older who underwent isolated aortic valve replacement at Groote Schuur Hospital between January 1969 and January 1979. Follow-up ranged from 1 year to 10 years, with a mean of 2,5 years. There was 1 operative death. Two patients died within the first 6 months of operative complications. The 1-year survival rate was 90%. All hospital survivors showed marked improvement in cardiac functional status. Actuarial statistics on survival show an 84% survival rate at 3 years. Aortic valve replacement is safe and effective in patients over the age of 70 years.

Aged↗

Normal cardiac function with a hybrid heart.

A left ventricular bypass procedure using a cardiac allograft was performed in a patient with a long history of rheumatic heart disease and two aortic valve replacements. Normal cardiac function was reestablished, and the only problem following transplantation was that of serious arrhythmias involving the recipient heart. Eighteen months after left ventricular bypass bacterial endocarditis which was resistant to medical treatment developed on the aortic prosthesis. The patient underwent operation, the prosthesis was removed, and the recipient left ventricle was partially resected and excluded from the circulation. Since then the patient has been asymptomatic and, at the time of writing three years after cardiac allograft, he is our longest survivor.

Arrhythmias, Cardiac↗

A profile of daily activity in chronic obstructive pulmonary disease.

BACKGROUND: Little information exists about the pattern of daily activity in patients with chronic obstructive pulmonary disease (COPD), especially in those who are on long-term oxygen therapy (LTOT). The aim of this study was to explore the regular level of domestic physical activity in patients with COPD and to explore differences in activity in those on LTOT. METHODS: Daily activity was recorded using an activity monitor for 7 consecutive days in 4 groups. Group 1 had severe COPD (FEV1 0.66 [0.42] L) receiving LTOT (n = 9). Group 2 had severe COPD (FEV1 1.07 [0.43] L) and had full knowledge of the activity monitor and the purpose of the study (n = 10). Group 3 had severe COPD (FEV1 1.16 [0.27] L) but were unaware of the precise nature of the study (n = 10). Group 4 (n = 10) were the healthy control group. Participants also completed health status questionnaires. RESULTS: There were statistically significant differences in the level of daily activity between all groups (P < .001) except between groups 2 and 3. There were no significant differences between days within groups. The activity counts compared to the healthy groups were reduced by 49% in groups 2 and 3 and by 79% in those on LTOT. CONCLUSION: Patients with COPD demonstrate reduced levels of spontaneous physical activity compared with healthy controls. Furthermore, patients receiving LTOT have an even lower level of domestic activity compared with that of those not on LTOT but with COPD of similar severity.

Activities of Daily Living↗