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Biomedical subjects

A Maggioni

Publications and source records attributed to A Maggioni.

At least 55 records · Page 3Linked to original sources
PubMed1994

Pefloxacin in the treatment of severe infections in gynecological cancer patients.

Infections often complicate the medical or surgical treatment of hospitalized cancer patients. In these cases, a broad-spectrum antibiotic treatment is necessary before the microbiological results are available. The aim of the present study is to verify the efficacy of pefloxacin as empirical antibiotic therapy in controlling infectious complications induced by surgery, chemotherapy or radiotherapy in female patients with gynecological cancer. To this purpose, 58 hospitalized patients with gynecologic malignancy and severe infectious complications were treated with intravenous pefloxacin at the dosage regimen of 400 mg every 12 hours. In all, 49 (or 91%) of the 54 evaluable patients were cured. The mean duration of successful treatment was 5.9 +/- 2.1 days (ranging 4-13 days). No side effects or clinical laboratory abnormalities requiring reduction or discontinuation of therapy were observed. We conclude that pefloxacin may be considered a first choice, broad-spectrum, single antibiotic for use in the empirical therapy of infections in gynecological cancer patients.

Adult↗
PubMed1994

New classes of antimuscarinic agents endowed with selective antispasmodic properties. 1-Arylsulfonyl pyrrolidin-2-ones and 2-thiones, 1-arylsulfonyl piperidin-2-ones and 2-thiones and 1-arylsulfonyl hexahydro-2H-azepin-2-one.

A series of 1-arylsulfonylpyrrolidin-2-ones (and 2-thiones), 1-aryl sulfonylpiperidin-2-ones (and 2-thiones) and 1-arylsulfonyl hexahydro-2H-azepin-2-one were synthesized and submitted to a battery of binding assays. The compounds showed little or no affinity for the receptors tested other than muscarinic receptors labelled either with [3H]pirenzepine or with [3H]quinuclidinyl benzilate. When tested in the isolated guinea pig ileum, they antagonized the contractions induced by acetylcholine and behaved as competitive muscarinic antagonists. After parenteral administration in mice, most compounds inhibited carbachol-induced diarrhoea but were less effective in counteracting salivation and lacrimation and showed little or no mydriatic action, thus displaying selectivity at the intestinal level. The reference drugs tested, atropine, butyl scopolamine and cimetropium bromide were far less selective. maximal in vivo activity was obtained by introducing diethylamino or 1-piperidino or 1-hexahydroazepinyl groups in the 4-position of the phenyl ring while the enlargement of a 5- to a 6-membered lactam ring or its conversion into a thiolactam had a less marked effect. The most interesting compounds were further evaluated for their ability to antagonize carbachol-induced colonic hypermotility in the rat and arecoline-induced analgesia in mice. The effect on gastric acid secretion in the rat was also investigated. The overall in vivo data showed that compounds 14, 15, 26 and 27, i.e. those bearing a 1-hexahydroazepinyl group in the 4-position of the phenyl ring, were the most potent and selective compounds.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Influence of blood transfusions on surgery-induced immune changes in colorectal carcinoma.

Perioperative blood transfusions have been shown to enhance recurrence rates in patients with operable solid tumors, perhaps by inducing immunosuppression through unknown mechanisms. Since the surgical treatment per se has been proven to induce immune alterations, the present study was carried out to evaluate the immune effect of blood transfusions on surgery-induced immune variations. The study included 27 patients with resectable colorectal carcinoma, 18 of whom received no transfusion, while the other 9 received blood transfusions in the perioperative period. Total lymphocytes, total T lymphocytes (CD3) and soluble IL-2 receptor serum levels (SIL-2R) were measured on venous blood samples collected from each patient either before or 7 days after surgery. Both in non transfused and in transfused patients, SIL-2R mean levels were significantly higher after than before surgery. Their increase was associated with a significant decrease in both lymphocytes and CD3 cells in non-transfused patients, while in the transfused ones lymphocytes and CD3 cells did not show significant changes with surgery. This study shows that blood transfusions modify the relation between changes in SIL-2R and those in lymphocyte number induced by major surgery. It remains to be understood which relation exist between these immune effects and the promoting action of blood transfusion on relapse frequency in cancer.

Adult↗
PubMed1993

Physical activity and the risk of acute myocardial infarction. GISSI-EFRIM Investigators. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto-Epidemiologia dei Fattori di Rischio dell'Infarto Miocardico.

The relationship between physical activity and acute myocardial infarction (AMI) was examined in a case-control study conducted in Italy in 1988 to 1989 within the framework of the GISSI-2 trial of streptokinase versus alteplase and heparin versus no heparin in the treatment of AMI. A total of 916 case patients admitted to coronary care units from various Italian regions for AMI were interviewed. Control subjects were 1106 patients admitted to the same network of hospitals for a broad spectrum of acute diseases not related to known or potential risk factors for myocardial infarction. Among various types of physical activity (occupational activity, walking, stair climbing, and sport and leisure-time physical activity), occupational physical exercise emerged as the most protective. Multivariate odds ratios (ORs) were 1.4 (95% confidence interval (CI), 1.0 to 2.0) and 1.6 (95% CI, 1.2 to 2.1) for the two lowest levels of occupational physical activity. The trends of increasing risk with decreasing activity were consistent, although less strong, when other types of activity were considered. The protection conveyed by occupational physical activity was similar across various strata of sex, age, education, smoking habits, and diabetes, and was not explained by serum cholesterol, body weight, or hypertension. This study therefore confirms that low physical activity is an indicator of subsequent risk of AMI.

Adult↗
PubMed1993

[Adjuvant interferon alpha in renal carcinoma with a high risk of recurrence. Multicenter pilot study].

Twenty-eight consecutive patients submitted to radical nephrectomy for Robson's stage II-III renal cell carcinoma underwent adjuvant recombinant a-2b interferon, 5 MUI s.c. 3 times a week, for 6 consecutive months. Home-feasibility of this therapy resulted easy. The most frequent acute (flu-like syndrome) and late (myalgia, fatigue, anorexia) side effects did not affect normal daily life of patients. Eight (28.5%) patients had WHO grade < or = 2 biochemical and hematological toxicity, that normalized after a reduction or a temporarily suspension of therapy. Twenty-seven patients were evaluable for response. Out of these, 7 (26%) relapsed after a 16 months median follow-up.

Adult↗
PubMed1992

[Current knowledge about metastatic neoplasms].

The best knowledge of the biological and genetic mechanism involved in the process of metastasizing must determine the attempt of elaborating new therapeutical modalities. The authors show the sequential events of the metastasizing process based on the most recent theories, underlining the way the organotropism of the neoplastic cells can be the explanation of the otherwise inexplicable metastases.

Animals↗
PubMed1992

[Clinical and prognostic significance of metastases].

The authors briefly illustrate some biological and epidemiologic characteristics of the malignant urologic tumors; then they describe the modalities of metastasizing underlining that this process is determined not only by hematic and lymphatic dissemination but also by sequential and complex events "metastatic fall", involving multiple guest-tumor intersections to the organotropism of the neoplastic cells and to their intrinsic aggressiveness and to the histological type of tumor. Afterwards the authors analytically analyze the most important malignant neoplasms of the urogenital apparatus either as clinical importance or as statistic incidence.

Adult↗
PubMed1991

[Morphofunctional changes in the left ventricle of the elderly person and the vulnerability to myocardial necrosis].

In the Western world the percentage of subjects over the age of 60 years is rapidly increasing. Therefore, elderly individuals represent a progressively increasing proportion of patients with ischemic heart disease (IHD), which is the most prevalent disease in this age range. In the elderly both the clinical presentation and the outcome of IHD have some peculiar features which may have important therapeutic implications. The prevalence of both coronary atherosclerosis and uncomplicated angina pectoris increases up to the sixth decade when it reaches a plateau. Conversely, the prevalence of myocardial infarction increases progressively at increasing ages without reaching any plateau at all. These findings indicate that the higher prevalence of myocardial infarction in the elderly is not caused by a worsening of the atherosclerotic background, but rather by a greater prevalence and/or severity of the functional factors such as local smooth muscle hyperreactivity, local thrombotic stimuli and alterations of the systemic thrombosis-thrombolysis equilibrium which are more directly responsible for the irreversible occlusion of a coronary artery branch. Therefore, the prevention of IHD in the elderly should focus mainly on the ischemic stimuli leading to coronary thrombosis rather than on the atherosclerotic background. Another important feature of IHD in the elderly is the high short and medium-term mortality of acute myocardial infarction. This excess of mortality is caused mainly by a much higher incidence of cardiac rupture, which does not appear to be related to the severity of coronary atherosclerosis nor to the infarct size.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

[Neoadjuvant chemotherapy using methotrexate and cisplatin in locally advanced urothelial cancer of the bladder].

Thirty-one consecutive patients with clinically and histologically documented urothelial cancer of the urinary bladder of category T3-T4a, N0, M0 underwent a trial of neoadjuvant chemotherapy before radical cystectomy. All patients received 2 courses of methotrexate 300 mg/m2 day 1 followed by folinic acid rescue days 2 and 3 and cisplatin 100 mg/m2 day 4, q. 3 weeks. Only responders were to receive 2 further courses of chemotherapy. The protocol was violated in 5 cases and all did poorly. Of the remaining 26 patients, 19 (73%) had a partial or complete remission to neoadjuvant chemotherapy. The actuarial disease-free survival was very encouraging at 18 months (87% for responders versus 43% for the 7 non responders), but at 30 months the difference became minimal (60% versus 43%). Furthermore, all 3 responders who had refused radical cystectomy relapsed locally. Postoperative randomized trials are necessary to prove the advantage of neoadjuvant therapy with a long term survival and bladder preservation.

Adult↗
PubMed1990

Neoadjuvant medium-dose methotrexate, cisplatin in category T3b-T4a (N0M0) bladder cancer.

Between July 1985 and December 1988, 31 consecutive patients with category T3b-T4a (NOMO) urothelial cancer of the urinary bladder were entered into a phase II study of neoadjuvant chemotherapy with medium-dose methotrexate (300 mg/m2 followed by folinic acid rescue), cisplatin (100 mg/m2 continuous i.v. infusion) every 4 weeks for a total of 4 courses. Six patients did not respond to the first two courses of neoadjuvant chemotherapy and another 3 were considered non-responders after 4 courses. Three of these 9 patients progressed and could not undergo salvage cystectomy. Only 4 patients (13%) entered complete remission, and one of them refused surgery. All the 18 (58%) partial responders underwent radical cystectomy. The overall 2-year disease-free survival is 72%: it is 100% for the 4 complete responders, 76% for the 18 partial responders and 56% for the 9 nonresponders. A longer follow-up is necessary to evaluate the impact of the neoadjuvant chemotherapy on survival of category T3b-T4a (NOMO) bladder cancer.

Adult↗
PubMed1989

One-year prognosis of primary ventricular fibrillation complicating acute myocardial infarction. The GISSI (Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto miocardico) investigators.

The 1-year prognosis of 293 patients discharged alive from the hospital after acute myocardial infarction (AMI), who experienced primary ventricular fibrillation (VF) in the acute phase, was compared with that of a reference group of 6,337 patients identified from the same population included in the Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto miocardico (GISSI) trial. There was no difference in the 6- and 12-month mortality between the patients with primary VF and the reference group (3.7 vs 2.7% and 4.1 vs 4.2%, respectively). Survival of the 2 groups was also similar when patients were stratified according to infarct site (anterior and posterior), and whether or not they received treatment with streptokinase during AMI. Thus, long-term mortality of patients discharged alive after AMI complicated by primary VF is low and is not influenced by previous fibrinolytic therapy or by infarct site. The excess mortality of patients with primary VF is confined to the hospital phase, after which survivors represent a low-risk subgroup.

Adrenergic beta-Antagonists↗
PubMed1987

In-hospital prognosis of patients with acute myocardial infarction complicated by primary ventricular fibrillation.

The in-hospital prognosis of patients with acute myocardial infarction complicated by primary ventricular fibrillation has not been satisfactorily defined. We addressed this question by studying patients with primary ventricular fibrillation derived from a large study (11,712 patients) of intravenous streptokinase in the treatment of acute myocardial infarction. Ventricular fibrillation was considered to be primary when it complicated a first myocardial infarction not associated with heart failure or shock and occurred within 48 hours of hospital admission. The 332 patients with primary ventricular fibrillation represented an overall incidence of 2.8 percent. A significant excess of in-hospital deaths was found in the patients with primary ventricular fibrillation as compared with those in the reference group (10.8 percent vs. 5.9 percent; relative risk, 1.94; 95 percent confidence interval, 1.35 to 2.78). Thrombolytic treatment with intravenous streptokinase did not afford protection against primary ventricular fibrillation. We observed that being over 65 years old had a protective effect against primary ventricular fibrillation (relative risk, 0.6; 95 percent confidence interval, 0.45 to 0.80). Our data do not indicate whether primary ventricular fibrillation is simply a marker for patients at increased risk of death or a direct cause of the increase in mortality. Our results do show, however, that primary ventricular fibrillation occurring in a coronary care unit is a negative predictor of short-term survival in patients with acute myocardial infarction.

Age Factors↗
PubMed1985

Two false-negative responses to the ajmaline test in the Wolff-Parkinson-White syndrome.

Anterograde block in the accessory pathway with a short effective refractory period was observed after intravenous (IV) injection of 1 mg/kg of ajmaline in two patients with the Wolff-Parkinson-White syndrome. The possibility of a false-negative response to this test is discussed. Ajmaline is proposed as an emergency drug in the Wolff-Parkinson-White syndrome in the setting of atrial fibrillation with a very high ventricular rate.

Adult↗
PubMed1983

ICRF 159 plus radiation versus radiation therapy alone in cervical carcinoma. A double-blind study.

In a double-blind trial the effect of ICRF 159 or placebo associated with radiotherapy was compared in 70 patients with cervical carcinoma. No significant differences were found on histopathological examination of surgical specimens obtained 6 weeks after the end of the treatment. Clinical evaluation after a follow-up of 46 +/- 5 months, also showed no significant effect of ICRF 159 with radiotherapy.

Carcinoma, Squamous Cell↗