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Biomedical subjects

C Barone

Publications and source records attributed to C Barone.

At least 73 records · Page 4Linked to original sources

Means-ends problem-solving skills, life stress, and social support as mediators of adjustment in the normative transition to high school.

Examined the transition of adolescents from middle school to high school through a longitudinal research design. Consistent with other studies, results indicate that the transition is associated with declines in grade point average and attendance, and that these changes persist or worsen over the course of the freshman year. Life stress and social support from family, friends, and school personnel each showed expected relationships with some outcome variables, though these varied in pattern and magnitude. Furthermore, there was some indication that these sources could be used in multivariate analyses in assessing their relationship to outcomes. Finally, means-ends problem-solving skills did not predict levels of posttransition support. Results are seen as supporting a differential model of the role of individual and environmental resources in the high school transition, especially with regard to the negative changes in grades and attendance and the pattern of correlations between social support sources and outcomes.

Adaptation, Psychological↗

Hepatocarcinoma in cirrhosis. Is antithrombin III a neoplastic marker?

It has been reported that hepatoma (HCC) cells produce abnormal proteins such as erytropietin, fibrinogen, prothrombin, and, recently, antithrombin III (AT III). In a preliminary report, we reported increased AT III levels in patients bearing HCC independent of their clinical liver status. The present study was performed to assess antithrombin III levels and other serological data present in patients with cirrhosis and in patients with cirrhosis and clinical findings of neoplastic disease. In 70 well-matched patients (47 with cirrhosis and 23 with cirrhosis and proven HCC) serum total cholesterol, albumin, prothrombin, alkaline phosphatase, AFP, aminotransferases, and AT III were determined. Together with AFP and alkaline phosphatase, patients with HCC had higher values of AT III (88 +/- 7%) and total cholesterol (184 +/- 17 mg/100 ml), as compared with cirrhotic patients (AT III 56 +/- 3.6%; total cholesterol 113 +/- 5 mg/100 ml) (P less than 0.001). No difference was observed between these two groups for albumin, prothrombin, and aminotransferases. In HCC patients, AT III levels were related to the total cholesterol level (R2 = 0.317), whereas in the cirrhotic patients it correlated with the prothrombin level (R2 = 0.274). These data suggest that in HCC patients a greater rate of synthesis of AT III occurs, whereas in cirrhotic patients lower levels of AT III occur due to impaired synthesis or increased catabolism of the protein. The serial determination of AT III in cirrhotic patients as a means of detecting neoplastic transformation is suggested.

Adult↗

5-Fluorouracil (FU) with folinic acid (FA) and mitomycin C (MMC) in the adjuvant treatment of colorectal carcinoma. Part I. Evaluation of toxicity.

Ninety-six patients with colorectal cancer (stage B2-C) were randomized to the control arm or to receive adjuvant chemotherapy with folinic acid, FU and MMC. Ninety-three patients are evaluable. The median follow up is 12 months. The average time between surgery and the start of therapy is 28 days. Toxicity is evaluable in 36 of 41 treated patients. Four patients (10%) failed to complete the projected treatment due to toxicity. Toxicity observed in 208 courses of therapy was mostly gastrointestinal and hematological. No cases of treatment related death or cancer-associated hemolytic uremic syndrome (C-HUS) were reported. The average relative dose intensity (rDI) of the projected treatment was 82.6%. Our study is ongoing and further patients are required to achieve statistically significant results.

Antineoplastic Combined Chemotherapy Protocols↗

5-Fluorouracil (FU) and mitomycin C (MMC) in the management of colorectal carcinoma. Part II. In vitro activity of the two drugs in short-term tumor cultures.

Eighty-seven colorectal adenocarcinomas from untreated patients were investigated by short term tumor cultures to test in vitro sensitivity to 5-fluorouracil and mitomycin C. This study reports the preliminary results of a multistep program aimed at the prospective clinical application of the assay. At present this in vitro experience was performed in parallel with a clinical trial carried out with the same drugs. The in vitro activity of the two anticancer agents is in agreement with the response rate reported in monochemotherapy; our data would suggest an increase of responses using the combination of fluorouracil and mitomycin in comparison to single drug therapy. A low cosensitivity rate and a high number of cases sensitive to one drug but resistant to the other, account for the use of this test as screening of active drugs in the individual patient.

Adenocarcinoma↗

Cell kinetics of gastrointestinal tumors after different nutritional regimens. A preliminary report.

Forty-four cases of different untreated gastrointestinal tumors were studied with regard to cell kinetic activity. As a pilot experiment, we also determined the 3H-TdR Labeling Index (LI) in 28 patients in basal conditions and after 15 days of nutritional manipulation with prevalently lipid-based or glucose-based feeding to ascertain whether selective nutritional regimens could affect tumor proliferation. Preliminary results from this study indicate that a kinetic perturbation is induced in tumor cells by nutritional manipulation. Lipid-based feeding seems to produce effects similar to those of chemical or physical anticancer agents, thus suggesting a possible supporting role of nutritional manipulation in cancer treatment strategy.

Aged↗

Association of epirubicin, etoposide and cisplatin in gastric cancer. A phase II study.

Cisplatin-based drug combinations are now currently investigated in an attempt to surpass the results obtainable by 5-FU alone or by 5-FU-containing regimens. We evaluated 29 patients with advanced and measurable gastric adenocarcinoma treated with etoposide, epirubicin and cisplatin. One patient had complete response (3 +/- 7%); 9 patients had partial response (31 +/- 17%); 5 patients (17 +/- 14%) were considered stable (S) and 14 (48 +/- 18%) were classified as progressive. The average survival time for the entire group was 11 months with 25% of the patients alive at 24 months. We feel that cisplatin-containing regimens are promising and deserve further investigations. To clearly explore the potential innovative role of these regimens randomized trials versus FAM or 5-FU alone are mandatory.

Adenocarcinoma↗

Role of immunoscintigraphy in clinical assessment of gastrointestinal tumors.

From June 1986 until April 1989 31 patients with gastrointestinal tumors were studied at follow-up for recurrences by immunoscintigraphy (IS) using F(ab)2 fragments of monoclonal antibodies anti CEA and anti CA 19-9. IS was employed to confirm the presence of metastases already found (group A) and to verify metastases suspected following physical and instrumental examinations and/or increases in CEA and/or CA 19-9 (group B). Thirty-four IS findings have been evaluated to date: 19 in group A, with 18 true positive and 1 false negative results; 15 in group B. In these patients there were 12 cases of pathologic high fixation: 6 were confirmed using standard examinations after a median follow-up of 1 month (range 1-12); 6 cases had no metastatic evolution at the suspected site after a follow-up of 5-28 months. In 3 cases IS was negative, these patients are disease free at 13, 14 and 24 months. In group B, 5 of 8 abdominal intense fixations were early diagnoses of local or peritoneal recurrences. The overall accuracy was 79.4% and it was not affected by circulating CEA levels; sensitivity was 96%. IS can be considered useful as a primary diagnostic examination in the follow-up of patients with suspected abdominal metastases.

Adult↗

Advanced colon cancer: staging and prognosis by CEA test.

The carcinoembryonic antigen (CEA) test was studied in 54 patients with advanced stages of colon cancer which was treated with high doses of folinic acid + fluorouracil. The CEA test correlates evaluated included: prognostic value, performance status, metastatic pattern, histologic grading, predictive value for response to chemotherapy, and value differences in cases with partial response to therapy. CEA levels less than 5 ng/ml corresponded to a greater survival time than did levels greater than 5 ng/ml. A correlation of CEA with performance status and with metastatic pattern was demonstrated. A progressive increase in average CEA values corresponded to increases in neoplastic mass. Although CEA levels were not found to be an index for predicting the response to chemotherapy, there was a significant different between pre- and posttreatment levels for partial response. The results suggest that CEA offers an additional criterion for evaluating the response of colon cancer to chemotherapy and it also has a role in the staging of advanced disease.

Adult↗

Circulating immune complexes detected by a direct nephelometric assay and acute phase proteins in malignant tumors.

Circulating immune complexes (CIC) were previously reported to be higher in extended cancer rather than in localized one, by a few groups of investigators as well as by ourselves. The techniques employed were quite different in each study. We described a "direct" laser nephelometric assay. At the same time we determined the serum levels of 4 acute phase proteins (AFP)--alpha 2 macroglobulin, C reactive protein, haptoglobin, alpha 1 acid glycoprotein--by conventional light scattering method, in order to investigate on other possible "immune-modulating" factors. The possible correlations either with prognosis or clinical stage are looked for; the hypothetical behaviour of CIC as one of the serum "blocking factors" and of acute phase reactant as "immune modulating" proteins are discussed. The data concerning the techniques able to remove CIC from the blood stream of the cancer patients were also showed (plasmapheresis and immunoadsorption).

Acute-Phase Proteins↗

A response in advanced post-menopausal breast cancer during treatment with the luteinising hormone releasing hormone agonist--Zoladex.

Luteinising hormone releasing hormone (LHRH) agonists are currently undergoing clinical trials in the treatment of advanced breast cancer in pre-menopausal women. Clinical responses are attributed to the suppression of the pituitary-ovarian axis, with a reduction in circulating levels of gonadal steroids similar to that produced by castration. In the present case report, we report a partial response to a LHRH analogue in a post-menopausal woman refractory to other endocrine treatments. This response cannot be explained with a chemical castration and confirms the possible direct anti-tumor effect of Zoladex.

Aged↗

[Medical therapy with mebendazole in hydatid cyst disease. A follow-up of 40 cases].

Mebendazole (50-60 mg/kg/day in 7-8 divided doses after fatty rich meals for at least 6 months) was given to 44 patients with cystic hydatid disease of the liver and other organs, about 1/3 having suffered from recurrences, even multiple, before beginning the pharmacological treatment. Fifteen patients underwent operation after a course of mebendazole, and macroscopic and histological degeneration of hydatid cysts was always documented; sixteen subjects were not operated due to their severe general and/or local conditions but ultrasound, radiologic (CT) and clinical evidence of cyst regression was obtained, and was closely comparable to that in the aforementioned group. Some of the patients (13) began the treatment only after conservative surgery. The mean real follow-up available at the moment is for 40 subjects because 2 patients did not show adequate compliance for the drug and in 2 additional cases it was withdrawn because of an increase in serum transaminases. The rate of recurrence was 7.5% and occurred in high-risk patients (multiple, bone, lung locations) who had, however, an additional and longer course of mebendazole with good results. The detachment of membranes and the increase of internal echoes, observed by means of ultrasonography, which was successfully applied to liver and soft tissue sites as well as the decrease in blood eosinophils when elevated before therapy, were observed to be the most sensitive indicators of early success in the medical treatment for hydatid disease, as far as the viability of parasite cysts was concerned.

Adolescent↗

Immune complexes in solid tumours precipitable by 3.5% polyethylene glycol: analysis of some nonspecific components.

Some nonspecific components (IgG, C3c, C4,) of circulating immune complexes (IC) precipitable by 3.5% PEG were assayed by laser nephelometry in the sera of 71 patients with solid tumours, and of 39 patients with autoimmune diseases. PEG-IgG, PEG-C3c, and PEG-C4 were higher in cancer and in autoimmune diseases than in controls. In cancer patients, PEG-C4 levels and PEG-C4 positivity rate correlated well with tumour burden. PEG-C3c and PEG-IgG were present at higher levels and PEG-C4 was present at lower concentration in cancer than in autoimmune diseases. The results of the present study, performed on a large population of patients with cancer and autoimmune diseases, indicate a different composition of circulating IC in these diseases. Particularly, these data suggest a preferential involvement of the alternative pathway of complement activation in cancer, as already described by other authors. The aggregation of C3c to IC, mediated by the alternative pathway, seems to be the "key" event in the process of IC solubilization. In cancer patients' sera, the presence of "solubilized" IC could partly explain their peculiar biological behaviour as well as the disagreement observed among the different assay methods based upon the binding with complement factors.

Antigen-Antibody Complex↗

High-dose folinic acid (HDFA) combined with 5-fluorouracil (5-FU) in first line chemotherapy of advanced large bowel cancer.

The therapeutic activity of 5-FU in large bowel cancer is enhanced by increasing the intracellular pool of reduced folates. We treated 45 patients with advanced colon cancer with HDFA and 5-FU for 5 consecutive days. None had been given previous radio- or chemotherapy. All had measurable disease. Not one complete response was observed. Thirteen of the 39 evaluable patients showed partial response. Median duration of response was 9+ months. The probability of 50% survival was 15 months for all evaluable patients. There was no case of severe toxicity and the principal toxic effects were oral mucositis and diarrhea. To date, HDFA + 5-FU is one of the most effective treatments for large bowel cancer.

Adult↗

Dementia-peripheral neuropathy during combined deficiency of vitamin B12 and folate. Light microscopy and ultrastructural study of sural nerve.

We present a case of a 56 year old woman who, in consequence of repeated surgical resections of the small bowel, developed a slowly progressive and mainly motor polyneuropathy affecting the lower limbs. The polyneuropathy due to a combined deficiency of vitamin B12 and folate, was associated with intellectual deterioration, involving especially the mnesic functions. Light microscopy and ultrastructural study of sural nerve revealed: marked reduction of every order of myelinated fibers: aspects of wallerian-like myelin degeneration; various stages of myelin leaflet delamination into the cytoplasm of Schwann cells and/or macrophages; lack of alterations attributable to a primary axonal degeneration. The morphological results suggest a primary demyelination, followed secondarily by either axonal changes or some aspects of wallerian-like degeneration.

Brain↗

Esophageal involvement in Behçet's syndrome.

Two patients with Behçet's syndrome had severe esophageal involvement. Both presented the complete clinical pattern (oral, genital, and eye lesions) of Behçet's syndrome. In both, esophageal lesions were associated with other gastrointestinal manifestations, in the first a transient episode of ulcerative ileitis, and in the second patient colitis. In both, the differential diagnosis with inflammatory bowel disease was very difficult. Histology of esophageal lesions was nonspecific; no vasculitis was found. Both patients improved on steroid therapy. Esophageal lesions also improved endoscopically and histologically with steroid therapy. When there is obvious gastrointestinal involvement in Behçet's syndrome, the differential diagnosis from inflammatory bowel disease is very difficult.

Behcet Syndrome↗