Search PubMed⌕ Search

Biomedical subjects

B Frea

Publications and source records attributed to B Frea.

At least 19 recordsLinked to original sources

[Does PSA density of the transition zone represent a useful parameter in the diagnosis of prostate carcinoma?].

Prostate specific antigen (PSA) has unequivocally proved its clinical usefulness ad a serum marker for prostate cancer. In order to enhance the specificity of serum PSA, several diagnostic parameters have been employed including PSA density of transition zone (TZ). The authors report their experience on the efficacy of PSA density TZ with level of PSA < 4 ng/ml, between 4-10 ng/ml, > 10 ng/ml, in the diagnostic of prostate cancer. The PSA density of TZ resulted uscless for PSA levels < 4 ng/ml, but improved the diagnostic specificity associated to PSA serum in the PSA levels ranging between 4-10 ng/ml and > 10 ng/ml.

Humans↗

[Voiding ultrasonographic cystourethrography].

Transvaginal ultrasonography examines the bladder base, the urethral anatomy and the relationship between these structures. This procedure particularly evaluates the striated sphincter and periutrehral structures, during micturition attention is focused on elasticity of urethral walls, deviation of urethral axis, the presence of fibrotic rings, fibrosis extending to the whole urethra and on urethral diverticuli. At che present, the literature available does not provide certain diagnostical criteria for the identification of female vaiding disorders. The high number of proposed therapeutical solutions indicate that the solution to this problem is yet to be found.

Female↗

[Clinical response and survival in metastatic renal carcinoma during subcutaneous administration of interleukin-2 alone. Subcutaneous Il-2 in renal carcinoma].

Several clinical studies have demonstrated the efficacy of subcutaneous immunotherapy with Il-2 alone in metastatic renal cell carcinoma (RCC). In an attempt to better define the clinical parameters which may predict the efficacy of treatment, the present study shows the results obtained with subcutaneous Il-2 alone in 91 evaluable metastatic RCC patients. IL-2 was injected subcutaneously at 3 million IU twice/day for 5 days/week for 6 weeks, corresponding to one immunotherapeutic cycle. In nonprogressing patients, a second cycle was given after 28-day rest period. A complete response (CR) was achieved in 2/91 patients. Moreover, 19/91 patients had a partial response (PR). Therefore, objective response (OR) rate was 21/91 (23%) patients. Stable disease (SD) was achieved in 41 patients, while the remaining 29 patients had a progressive disease (PD). OR rate was significantly higher in patients with a long disease-free survival than in patients with synchronous metastases, in nephrectomized patients than in the non-nephrectomized ones, and in patients with high than in those with low PS. The survival obtained in patients with CR or PA was significantly longer with respect to that found in patients with SD or PD. The toxicity was substantially low in all patients. This study confirms that the subcutaneous immunotherapy with IL-2 alone is an effective and well tolerated therapy of metastatic RCC.

Adult↗

[Preoperative subcutaneous immunotherapy with interleukin-2 in renal carcinoma with synchronous metastasis: randomized clinico-biological study. Preoperative use of Il-2 in renal carcinoma].

Despite the efficacy of IL-2 in the treatment of metastatic renal cell carcinoma (RCC), the prognosis of patients with synchronous metastases still remains poor. Nephrectomy itself, as well as other surgical operations, may further suppress the antitumor immune response. Previous studies suggested that the preoperative injection of IL-2 may neutralize surgery-induced lymphocytopenia in advanced colon cancer. On this basis, a pilot randomized study was performed in an attempt to evaluate the effects of a preoperative administration of IL-2 on postoperative lymphocyte numbers and on the survival in advanced RVV patients with more than 3 synchronous metastases. The study included 20 consecutive patients, who were randomized to receive nephrectomy alone or nephrectomy plus preoperative subcutaneous immunotherapy with IL-2 (18 million IU/day for 3 days). Then, all patients underwent postoperative immunotherapy with IL-2 (6 million IU/day for 5 days/week for 6 weeks). Surgery-induced lymphocytopenia was completely abolished by IL-2 preoperative injection. The frequency of postoperative complications was significantly higher in controls than in patients preoperatively treated with IL-2. On the contrary, significant differences between control and patients preoperatively treated with IL-2 were observed neither in the clinical response to IL-2 immunotherapy, nor in the percent of 1-year survival. The results of this preliminary pilot study would suggest that IL-2 preoperative immunotherapy may neutralize surgery-induced lymphocytopenia and reduce the postoperative complications in RCC patients with synchronous metastases, without, however, influencing their prognosis in terms of survival time.

Adult↗

[Orthotopic ileal neobladders in men and women: techniques and comparison].

PURPOSE: evaluation of results and complications of ileal orthotopic neobladders in men and women with transitional cell carcinoma. MATERIALS AND METHODS: between 12-89 and 12-95 we performed 146 radical cystectomy for bladder neoplasm, in 32 patients we can perform ileal orthotopic neobladder, 29 were male and 3 were female. Oncologic indications to this kind of operation were: clinical stage T2, T3a, T3b, T1G3 multicentric and or recurrence, absence of metastasis absence of nodal metastasis, negativity of urethral biopsy. General contraindications were urethral stenosis and incontinence. Oncological contraindications, in woman, were bladder neck neoplasm or urethral neoplasm. In 4 patients we use Camey II technique, in 19 pts we performed the paduan ileal neobladder, in 9 pts we use Hautmann technique. 7 patients performed neoadjuvant chemotherapy with 4 circles of MVAC, 4 pts underwent adjuvant chemotherapy, and 2 pts salvage chemotherapy. In woman we take care during cystectomy to dissect cardinal ligament very close to cervix uteri, to resect the uterosacral ligament far to the sacrum. We did not dissect under the ureter and we cut the urethra 0.5-1 cm far from the bladder neck. RESULTS: follow up was between 6 and 66 months. 24 patients are now alive and disease free, 2 patients are alive with disease progression, 1 have a pelvic recurrence and 1 have pulmonary recurrence. 4 pts died for disease progression and 2 for non oncological cause, quality of life was considered as regard to continence and sexual activity. 1 pts was completely incontinent and 1 pts has nocturnal incontinence with a daily micturation every 1 hour. We can evaluate only 18 patients for sexual activity and 4 reported normal erection. COMPLICATIONS: in three cases we had to reoperate for early complications due to mechanical bowel obstruction, ileocutaneous fistula and wound dehiscence. In three cases we had the formation of stones, in two patients ureteroileal stenosis, in two cases urethro-ileal stenosis and 1 reflux from the neobladder. Orthotopic ileal neobladder allows a very good quality of life and is the first choice derivation after radical cystectomy.

Antineoplastic Combined Chemotherapy Protocols↗

[Radical prostatectomy: comparison of technics].

From 1989 until today 46 patients aged 44-75 years underwent a radical prostatectomy two of whom transperineal and another 44 patients underwent a retropubical prostatectomy (twenty of whom with the nerve sparing technique). Based on our experience, the clinical stages that benefit from a radical prostatectomy as are as followed: T1b, T1c, T2a, T2b; T2c, in patients who present a good A.S.A., a remaining life-span of ten years is expected. Our preference, regarding the best access was clearly the traditional retropubical which allowed us on a preliminary bases a bilateral iliaco-otturatorial lymphoadenectomy with extemporaneus histological exams. Based on our experience we do not see an indication for a radical surgical intervention in the following with: P.S.A. higher than 60 ng./ml in patients with a clinical stage C. Positive abdominal-pelvical computer tomography for macrometastical lymph nodes. Positive bone scintigraphy. Patients over the age of 75 years.

Aged↗

[Involvement of the urogenital system in HIV virus infection].

Despite the genitourinary system is prone to infections by the Human Virus of Immunodeficiency, so far poor interest has been focused on urological manifestations of AIDS. We thoroughly reviewed the Literature and examined the different patterns of HIV infections on the kidneys, the prostate and the testes. An extensive description is given.

HIV↗

[Transvaginal echocystourethrography].

The anatomo-physiologic appearances of female urination obtained with a new ultrasonographic technique is illustrated. The technique is performed using an intravisceral linear probe positioned in the vagina and a special chair which allows the urination in physiological position; at the same time the urination is videorecorded. The results, compared with X-Ray cystourethrography, enabled us to show the normal aspects (both dynamic and morphologic) and several pathologic aspects. Basing upon the direction of the urethra, it is possible to establish the change of the position of the floor and the neck bladder, which are often responsible of stress incontinence. The Authors stress the relative simplicity and noninvasiveness of the echographic technique. X-Ray radiation aren't used: this test is particularly advisable to study the urination disease of women in fertile-age.

Adult↗

Correlation between liver cirrhosis and benign prostatic hyperplasia: a morphological study.

In elderly males hormonal changes occur, that are believed to cause benign prostatic hyperplasia (BPH). These are decreased testosterone production, an increased testosterone SHBG and a slightly increased estradiol production. Liver cirrhosis in males causes similar endocrine changes. We carried out a post mortem study evaluating the prostates of 51 men who died with liver cirrhosis compared with a similar group without any hepatic disease. The occurrence of BPH in cirrhotic subjects was diminished and delayed compared to total population. Furthermore in cirrhotic men BPH is more common as early nodular hyperplasia (early stage) or stromal hyperplasia (suggesting estrogenic prevalence), while in the general population stromal and epithelial hyperplasia (androgenic stimulation), were almost equally present.

Adult↗

[The urethral canal in the prostatectomy patient. Echographic aspects].

An evaluation of the urethra has been made in patients who underwent open surgery or endoscopic resection of the prostate, by means of transrectal echography (EG). The technique used is described; studies have been performed both in basal conditions and in various functional phases, including micturation. Echographic findings are compared to those achieved with micturating cystourethrography (MCU). In case of total prostatectomy EG and MCU findings are similar, showing the surgical bladder neck and the urethral aspect even during micturation. EG shows furthermore possible liquid fluid collections. In partial prostatectomies EG and CUM findings differ, showing the first, besides the site of the surgical intervention, the possible presence of calculi, while CUM findings do not differ from those visible in total prostatectomies. Conclusions are that for the whole study of the urethra CUM is necessary, while for the study of the prostatic region EG gives more information. Therefore EG is proposed as method complementary to CUM in the evaluation of the proximal urethra.

Humans↗

Bladder cancer and cigarette smoking in males: a case-control study.

Cigarette consumption was compared between 355 males with cancer of the lower urinary tract and 276 male hospital controls. Both duration of smoking and average daily consumption of cigarettes showed a dose-response relationship with risks of developing bladder cancer. Quitting smoking seems to have a protective role, whereas higher relative risks are associated with an early age at start of smoking. The use of a filter seems to have a weak protective effect.

Adolescent↗

Andrological and hormonal findings in subjects with ductus deferens agenesia.

The aim of our study has been the complete andrological and endocrinological evaluation of seven cases of bilateral ductus deferens agenesia. In all cases testicular biopsy demonstrated a normal spermatogenesis. Urographic examination showed, in four cases, the existence of congenital anomalies of the urinary tract. The presence of spermioagglutinating and spermimmobilizing antibodies in blood and in seminal plasma was excluded in all cases. Basal and stimulated levels of FSH, LH, PRL and testosterone were within normal limits. Surgical exploration of seminal tracts and bilateral collection of sperm at the caudal portion of the epididymis appear to be mandatory in order to select the cases for surgical therapeutic approach.

Adult↗