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Biomedical subjects

A Rizzo

Publications and source records attributed to A Rizzo.

233 records · Page 13Linked to original sources
PubMedDate not supplied

Hepatic and splenic mycosis in children with acute leukemia.

Three cases of hepatic and/or splenic mycosis in children with acute leukemia are reported. Patients presented with fever not responding to broad spectrum antibiotics during or after prolonged and profound neutropenia. Noteworthy, in 1 case no abnormality in liver function tests was detectable at diagnosis. CT scan showed focal hepatic lesions in all patients. In 1 patient ultrasounds failed to detect hepatic lesions and showed only splenic lesions, while CT scan detected hepatic and not splenic lesions. Definitive diagnosis was performed by open liver biopsy and histological demonstration of fungal invasion. Cultures were negative in all cases. All patients survived with prolonged amphotericin B treatment (from 36 to 40 mg/kg), combined with flucytosine in two cases. In conclusion, this clinical entity should be taken into account by physicians taking care of neutropenic patients, even in the absence of abnormalities in liver function. CT seems to be the method of choice for diagnosis, although ultrasounds might be useful for detecting concomitant splenic lesions.

Adolescent↗
PubMedDate not supplied

[Absorption, distribution, excretion and metabolism of 4-carbomethoxythiazolidine chlorohydrate. Biochemical experimental study in the rat].

A biochemical-metabolic study has been conducted on TCM (4-carbomethoxythiazolidin hydrochloride) in rats, utilising a product traced with 14C. An in-vitro test has demonstrated that TCM is hydrolised by endogenous esterases to thiazolidincarboxylic acid, into the following decreasing order of activity: kidneys, lungs, plasma, liver, intestinal content and mucosa. Upon oral administration, TCM proved to have a good and rapid absorption and distribution level in the organs. In the beginning the liver and the kidneys have displayed higher concentrations with respect to the lungs; after 8 hours, however, the latter have displayed slightly lower concentrations than before, which were not very far from the liver's and kidneys'. TCM has been mainly eliminated through the urines (56.9% in 24 hours) and less through the feces (6.7% in the same period of time). By means of a thin-layer chromatography analysis and a mass-spectrometry it has been possible to study the metabolism of TCM. The results of both in-vitro and in-vivo tests have demonstrated that TCM is hydrolised to thiazolidin-carboxylic acid, which, in its turn, is transformed into cysteine. This last transformation does mainly occur in the liver, but significantly in the lungs as well. TCM is absorbed in part as such and in part as thiazolidincarboxylic acid. As no methyl-cysteinate has been traced, it has been assumed that the hydrolysis of the ester bond was a kinetically quicker event than the heterocycle opening.

Animals↗
PubMedDate not supplied

[Correlations between laboratory and ultrasonic diagnosis and needle biopsy in chronic hepatitis and alcoholic cirrhosis].

A report is presented on patients admitted to hospital with chronic hepatitis or alcoholic cirrhosis of the liver and subjected to diagnostic laboratory tests, ultrasound scans and needle biopsies both non-surgical and during laparoscopy. The laboratory findings were compared with the results of ultrasound scans and biopsies. It was concluded that the diagnostic accuracy of ultrasound scans is sufficient, when backed by anamnestic clinical and laboratory data, to obviate the need for liver biopsy in cases of chronic hepatitis and alcoholic cirrhosis. Nor is biopsy required for differential diagnosis between the two conditions but should be reserved for the setting of diagnostic uncertainty about cancer-cirrhosis, or the presence of hepatoma, liver metastases, ascites or other oedematous forms. It is concluded that the undoubled diagnostic accuracy of biopsy does not compensate for the risk entailed especially for patients of this type.

Adult↗
PubMedDate not supplied

[Lip pits and Van der Woude syndrome. Description of a new familial case].

The authors describe the case of a family in which two siblings affected by cleft palate and cheiloschisis were diagnosed as suffering from van der Woude's syndrome (VWS). The diagnosis was largely determined by the finding of mucous cysts (lip-pits) on the lower lip of the two patients and their mother. Classification as VWS enabled genetic counseling as to the risk of recurrence to be modified from multifactorial to autosomal dominant. The authors also consider aspects of differential diagnosis among van der Woude syndrome, pterygo -popliteal syndrome and labio or palatoschisis syndrome with filiform fusion of the eyelids.

Adolescent↗
PubMedDate not supplied

[Advantages of a permanent venous access in children treated for cancer. Preliminary results].

Current therapy for children with cancer includes a variety of invasive procedures many of which require repeated venous access over a considerable period of time. Such procedures are poorly tolerated by children and by their veins. Recently it has become possible to undertake the majority of such procedures by means of permanent indwelling silastic catheters improving the quality of life of the children and their parents and increasing the scope of therapeutic intervention. In the period July '83 - August '84 we have used 46 of these catheters in 45 children with malignant disease, 12 with acute myeloid leukaemia, 12 with neuroblastoma, 7 with B cell leukaemia-lymphoma, 6 with rhabdomyosarcomas, 2 with Ewing's Sarcoma, 2 with Wilms' tumor and 1 case each of Hodgkin's disease, teratocarcinoma, osteosarcoma and juvenile chronic myeloid leukaemia. The children's ages ranged from 2 months to 14 years; 22 were male and 23 female. The catheters were inserted under general anaesthesia (duration 20-40 minutes) usually without difficulty, except for a single patient in whom no suitable vein could be found. No complications connected with the placement of the catheter were observed. Subsequent management of the catheter was initially complicated and time-consuming, but was subsequently simplified so that acceptance by parents, children and nursing staff was eventually excellent. The duration of use of 46 catheters ranges from 7 to 350+ days; 24 catheters are presently in use at 30-350+ days from insertion. Eight children died as a result of disease progression and two of sepsis with the catheter in place.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Neuroblastoma at the Giannina Gaslini Institute. Analysis of 94 cases diagnosed 1972-1981].

The authors have analysed 94 consecutive previously untreated children affected by NB diagnosed at the Giannina Gaslini Children's Hospital in the period January 1972 - December 1981. Age at diagnosis ranged between 1 month - 16 years (median 2 years). Diagnosis was made on histological grounds in 82 cases, on clinical, instrumental and laboratory data in the remaining 12 cases. Evans' staging system was adopted for classifying the disease extent. Patient recruitment was 9.4 cases for year. Female sex slightly prevailed in our series. 17 patients had localized disease (stage I and II), all surviving since 27 - 90 months. 28 children had regional disease (stage III) half of whom are presently alive. Five of the 47 cases with disseminated disease are alive at the time of this study; only one of these 5 can be considered cured, having been followed since more than 4 years. One of the two IV-s stage children survives disease-free at 89 months. 49% of patients were 2-year old or less at diagnosis while only 2 patients were older than 10. Survival was best in children diagnosed under one year of age, lowest in the 2 - 6 year age group. 74% of patients had their primary located in the abdomen (36 in the adrenal, 16 in sympathetic ganglia, 18 in un unidentifable site). Prognosis was worse in these patients compared with those with primary in the thorax, neck and pelvis. The clinical presentation of the disease has been extremely various: most patients had a diagnosis different from the definitive one, and were accordingly treated usually for several weeks or even months. Among laboratory data, urinary catecholamine metabolites, serum LDH and serum ferritin represented the most suitable indices of disease activity. Among immunological studies, none has shown a good correlation with the extent of the disease, nor with the clinical course. Stage I children had only surgery as treatment, while in stage II surgical ablation was followed by short-lasting chemotherapy and radiotherapy in few cases. In stage III and IV more complex multidisciplinary approach was utilized in the attempt to achieve a complete tumor regression. While about a half stage III cases appears curable by these treatment modalities, little impact has been demonstrated by this therapy in widespread disease, although the use of well-designed protocols seems have improved the complete remission rate and the median length of survival.

Adolescent↗
PubMedDate not supplied

Theophylline pharmacokinetics in patients with mild or severe airway obstruction.

A standard loading dose of aminophylline, followed by constant rate infusion for 3 h was used to study theophylline pharmacokinetics in 36 patients (age range 27-73 years) admitted to hospital during an exacerbation of chronic airway obstruction. The severity of the disease was assessed by peak expiratory flow rate and blood gas analysis. It was assumed that the severity of the disease and the patients' age, sex and smoking habits were relevant in predicting individual kinetics and hence in establishing individual theophylline dosage. Multiple regression analysis of the results failed to confirm this hypothesis and showed no significant relationship between the severity of the disease and pharmacokinetics even when other biological variables were taken into account. The results confirm the importance of careful monitoring of blood levels of theophylline since they cannot be predicted from functional indices of the severity of obstructive lung disease.

Acidosis, Respiratory↗
PubMedDate not supplied

[Ewing's sarcoma. Results of treatment in 16 consecutive cases].

In the period January 1974-August 1981, 16 previously untreated cases of Ewing's Sarcoma have been diagnosed at the Giannina Gaslini Children's Hospital Genova. Eight were male, eight female. Median age at diagnosis was 11 years. Two patients presented with a unique metastatic lesion, in the right lung and in an illiac lymph node, respectively. Fourteen patients have been initially treated with local radiotherapy (dosages ranging form 4,800 to 6,600 rads) in association with antiblastic polichemotherapy utilizing 4 drugs (Adriamycin, Actinomycin D, Vincristine, Cyclophosphamide). The Rosen et al.'s T-2 protocol was adopted, modifying the initial phase in order to give more weight to Adriamycin and reduce the toxic effects related to radio-chemotherapy combination. Two patients bearing a costal primary were immediately treated with a more complex and aggressive chemotherapy (T-6 Protocol), followed by local irradiation (in one case preceded by surgical ablation) and then chemotherapy again (T-2 protocol, second phase) for 10 months. Treatment determined a fast subjective relief in the 13 symptomatic patients. All 16 cases achieved a status of complete remission. Four of them subsequently relapsed: locally in two, in distant sites in the remaining 2. All 4 died 12-27 months form diagnosis. Twelve patients are presently alive without evidence of disease at 3-92 months (median 37 months) following diagnosis. Treatment has caused early and delayed toxicity in all cases. However, the entity of these complications varied considerably from one patient to an other. Age at diagnosis and site of primary tumor were the factors most relevant in this respect.

Adolescent↗
PubMedDate not supplied

Evaluation of a test of density-dependence of the expiratory flows in the screening of peripheral airways obstruction.

A test of density-dependence of flow at 50% of vital capacity has been investigated in two groups of subjects (86 in total) in order to evaluate respectively: a) influences that on it may be exerted by altered mechanical properties of the lung in chronic airflow obstruction; b) accuracy and precision of the test in latent and clinical asthma. Lung elastic recoil pressure does not seem to be related to the intensity of density-dependence. Relationships between MEF50 on air and on He-O2, expressed as means of groups allow distinguish between each other, whereas a definite overlap between groups is patent; absolute flows, either on air or on He-O2 are quite satisfactorily reproducible, both in health and disease. Delta% MEF50 shows a good specificity but a poor sensitivity; reproducibility is unacceptable, unless when using on a qualitative scale of figure of 20% as borderline to distinguish subjects responders from non responders.

Airway Obstruction↗
PubMedDate not supplied

High-dose therapy and autologous transplantation in amyloidosis-AL.

A 53-yr.-old woman with amyloidosis AL was treated with high-dose chemotherapy and autologous stem cell infusion in an attempt to suppress the amyloid secretion. A diagnosis of MGUS had been made six years earlier. During the last year her disease had progressively shifted to a full-blown picture of amyloidosis AL, with renal failure, proteinuria, renal amyloid deposition and plasma cell sheets in the marrow. After an unsuccessful attempt with standard-dose chemotherapy, she received a high-dose regimen of busulphan (14 mg/Kg) and melphalan (40 mg/m2), followed by the infusion of both autologous bone marrow and peripheral blood stem cells. She had full and prompt engraftment, but eight weeks post-graft developed interstitial pneumonitis: CMV was isolated. The patient died while in the intensive care unit. In the literature, this is the first case of amyloidosis AL treated with high-dose therapy and autologous transplantation.

Amyloidosis↗
PubMedDate not supplied

PCNA/cyclin expression in breast carcinomas: its relationships with Ki-67, ER, PgR immunostainings and clinico-pathologic aspects.

By the monoclonal antibody PC10, the Authors have analyzed the proliferating cell nuclear antigen (PCNA) immunoreactivity on fixed and unfixed specimens of breast ductal (42 cases) and lobular carcinomas (15 cases) as well as in normal breast tissue adjacent to carcinomas; for all cases the post-surgical staging as well as immunohistochemical data concerning ER and PgR receptors were available. In addition, the immunohistochemical pattern of Ki-67 has been also recorded. The study documented a constant expression of PCNA in all breast carcinomas with an heterogeneous pattern whereas the immunoreactivity for Ki-67 appeared less represented and focal, so that a linear relationship between PCNA and Ki-67 immunostaining was absent. Moreover, the chi-square test failed to show any correlation between PCNA and immunocytochemical demonstration of ER and PgR receptors, dimensions of tumours, histological grade and lymph node involvement. The PCNA expression in adjacent morphologically normal breast tissue may suggest an accumulation of cyclin without a necessary induction of DNA synthesis.

Adult↗