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Biomedical subjects

C Biagini

Publications and source records attributed to C Biagini.

At least 37 records · Page 2Linked to original sources

Information on radiation hazard and on radiological protection in medical school in Italy.

The state of teaching Radiation Protection in Medical School in Italy was considered. An historical approach was utilized, in order to define periods of time characterized by different conditions. Some data are collected by a concise enquiry on the information given during the course of Radiology in the second triennal cycle, and on some other teaching courses including information on radiation effects. The conclusion is that teaching times are exceedingly reduced, and the need of improving the diffusion of knowledge in the field is stressed. An official Act of the OECD and of European Community is expected, with the aim of emphasizing the importance of the information of doctors on Radiation protection as a problem of public interest. A proposal is advanced of implementing the Teaching of Radiobiology in the second triennal cycle, changing the name of the course in "Radiobiology and Radiological Protection".

Humans↗

Nephropathies and exposure to perchloroethylene in dry-cleaners.

Even in specific risk groups, the relation between exposure to organic solvents and chronic renal diseases remains controversial. Thus, in a collaborative European study, we assessed the renal effects of occupational exposure to perchloroethylene (PCE) in dry-cleaners compared with matched controls who were simultaneously examined. Single high and low molecular weight proteins, kidney-derived antigens and enzymes, and prostanoids were measured in urine. beta 2-microglobulin, creatinine, laminin fragments, and anti-glomerular basement membrane antibodies were also measured in serum. A canonical function based on 23 such variables correctly classified 93% of individuals as either PCE-exposed or controls; with 13 markers, group membership was identified in 87% of subjects. Increased high molecular weight protein in urine was frequently (17/50 vs 1/50, p less than 0.0001) associated with tubular alterations. Changes were consistent with diffuse abnormalities along the nephron in workers exposed to low levels of PCE (median 15 parts per million). Generalised membrane disturbances might account for the increased release of laminin fragments, fibronectin, and glycosaminoglycans, for high molecular weight proteinuria, and for the increased shedding of epithelial membrane components from tubular cells with different location along the nephron (brush-border antigens and Tamm-Horsfall glycoprotein). These findings of early renal changes indicate that solvent-exposed subjects, especially dry-cleaners, need to be monitored for the possible development of chronic renal diseases.

Adolescent↗

Recurrence of Hodgkin's disease after 10 years: observation of 5 cases.

Five patients whose Hodgkin's disease recurred 10 years or more after the achievement of complete remission are reported. Four out of 5 patients had shown an advanced stage at the onset of disease and therefore had received combination chemotherapy (ABVD or MOPP-like) as primary treatment. Involved-field irradiation was delivered as consolidation therapy in 1 patient only. All pathologically proven relapses occurred in a previously affected area and the histologic subtype differed from the primary subtype. The time interval between the achievement of the first complete remission and the relapse was 120, 170 and 190 months in 3, 1, and 1 patient, respectively. All 5 patients are alive in second complete remission. This paper emphasizes the risk of late relapse even after a prolonged disease-free interval for patients with Hodgkin's disease. Close follow-up is therefore recommended also in this clinical setting.

Adult↗

[Morphofunctional correlations in children with upper maxillary endognathia].

In this study 23 oral breathing children suffering from maxillary hypoplasia (endognathia associated with skeletal class II or III), selected for rapid maxillary expansion (RME) have been investigated by active anterior rhinometry. None of these patients presented O.R.L. pathologies during clinical examination except for some sporadic cases of adenoid hypertrophy (5 cases). Rhinomanometric and cephalometric examinations carried out before and after RME treatment showed a good correlation between the nasal respiratory function parameters and the structural cephalometric elements investigated by means of teleradiography. In particular, an important reduction in nasal respiratory resistance in all patients with conversion from oral to nasal respiration in the majority of cases corresponds, together with cross-bite resolution, to increased transversal dimension of the maxilla produced by RME. A clear regression in adenoid hypertrophy, where present, is also noted without any type of O.R.L. treatment. The improved respiratory situation could therefore produce benefits on the trophism of the nasal mucous and the lymphatic rhinopharyngeal tissue. Agreement between clinical, radiological and rhinomanometric findings confirm the usefulness of this method in diagnosing and following-up patients with this problem.

Adolescent↗

[Role of endovesical echography in the assessment of bladder neoplasms].

The correct assessment of T (depth of infiltration of bladder wall by cancer) is relevant to plan therapy. In fact, besides staging the local lesion, this can predict pelvic and lumboaortic lymphnode involvement (N parameter) statistically. At the INRCA Hospital in Florence, from January 1987 to December 1989, transurethral US was performed on 66 patients affected with bladder carcinomas, in order to assess the value of this diagnostic method; in all patients pathologic staging on surgical specimens from TUR (63 cases) and cystectomy (3 cases) was performed. Follow-up lasted 24 months at least. When comparing US staging (according to Holm classification) to postoperative histopathologic findings, our results showed that US tends to overstage the lesions, while no understaged tumors were seen in our series. Diagnostic accuracy was 70%. It must be pointed out that TRUS demonstrated hidden submucosal tumors in two patients previously treated with intravesical chemotherapy. Retrospectively, we were able to detect causes of error in cancer staging in some cases--i.e., large carcinomas, calcifications on tumors, radiotherapy scars, bladder wall inflammation due to intravesical BCG therapy. Moreover, some lesions which appeared to have been overstaged with TRUS and which had been treated according to histopathologic findings from TUR exhibited recurrence or disease progression. This was probably due to incomplete TUR and to the presence of residual tumor in the bladder wall.

Humans↗

Micronucleated lymphocytes in people occupationally exposed to potential environmental contaminants: the age effect.

This work is part of a research project on 2 groups of tannery workers (i.e., workers employed in the tanning process and those employed in the finishing department), and 2 control groups consisting of individuals paired with each exposed person according to sex, age and smoking habit. The whole study included the evaluation of micronuclei as well as of chromosomal aberrations and sister-chromatid exchanges in peripheral blood lymphocytes. Data on micronucleus analysis in both controls and exposed persons are shown in this paper. There was no statistically significant difference between MN frequencies in the 2 groups of exposed and controls, nor any positive correlation with smoking habit. The effect of age on basal frequency of micronucleated cells clearly emerges in the present study: both controls and exposed show an increase in MN frequency due to age. This could be correlated with a higher sensitivity to breaks, rearrangements or aneuploidogenic events of circulating lymphocytes in aged people.

Adult↗

[Clinical radiobiology of fast electrons].

The characteristics of microdosimetry, in terms of "lineal energy" value distribution, differ widely between high energy photons and electrons, so as to explain the existence of measurable RBE differences. Nevertheless one can accept for clinical purposes the RBE value 0.9 and a correlated dose increment of 10%. Most important are the macrodosimetric features of electron beams. As far as the skin reactions are concerned, they depend on many factors and are gaining a new relevance in clinical radiotherapy, being a guide in the treatment policy for a given patient.

Electrons↗

The role of restaging laparotomy in Hodgkin's disease.

The role of restaging laparotomy (RL) in Hodgkin's disease was studied in 41 patients. Two patients were in clinical stage I, 16 in clinical stage II, 13 in clinical stage III and 10 in clinical stage IV. Eight cases had previously received radiation therapy alone, 26 chemotherapy and 7 combined chemo-, and radiotherapy. The patients were divided into 2 groups, depending on the results of the preoperative clinical reevaluation. Group 1 included 20 patients with suspicion of persistent disease; in 6 (30%) RL was positive. Group 2 consisted of 21 cases with clinical appearance of complete response; RL was positive in one case (4.7%). The results of the comparison confirm the high rate of false positive findings in CT and lymphography. RL appears as a valuable procedure in patients with positive or doubtful clinical findings at reevaluation after radical therapy, in order to reduce the risk of unnecessary treatment.

Adolescent↗

Pretreatment scalene node biopsy in cervical carcinoma.

To evaluate incidence of scalene node metastases from carcinoma of the cervix, 20 patients had scalene fat-pad node biopsy. All cases were staged according to FIGO criteria and abdominal lymph nodes were studied by CT and lymphangiography. Scalene node metastases were found in 2 patients with clinically suspicious node and pelvic and paraaortic nodes involvement. Seven patients had sinus histiocytosis in scalene node biopsy and this seems related to a more favourable prognosis. From this study it appears that scalene node biopsy is not a routine procedure and should be performed in all patients with palpable supraclavicular masses or when paraortic nodes are involved.

Biopsy↗

Sequential combination chemotherapy of high-grade non-Hodgkin's lymphoma with 5-fluorouracil, methotrexate, cytosine-arabinoside, cyclophosphamide, doxorubicin, vincristine, and prednisone (F-MACHOP).

An intensive treatment program was developed to achieve durable remissions in a high proportion of previously untreated patients with advanced stages of diffuse high-grade non-Hodgkin's lymphoma (NHL). Fifty-six patients (15-68 years) received a course of F-MACHOP (5-fluorouracil, methotrexate, cytosine-arabinoside, cyclophosphamide, doxorubicin, vincristine, and prednisone) every 3-4 weeks for 6 courses. Cycle active drugs were sequentially administered to expose rapidly proliferating tumor cells to the synergistic effects of these agents throughout the cell cycle. Forty-three patients achieved complete remission (77%) and 80% of the complete responders are projected to be alive and disease-free at 4 1/2 years (median follow-up 33 months). Up to 70% of all patients are predicted to be alive at 5 years. Bulky tumor, "B"-symptoms and lymphoblastic histology were poor prognostic factors, particularly when associated with clinically detectable disease after three courses. Toxicity included transitory myelodepression in most patients (2 septic deaths). This protocol provides effective and tolerable therapy for the majority of patients with advanced stages of diffuse aggressive NHL.

Adolescent↗

[Evaluation of the process of lumbo-aortic metastasis in carcinoma of the cervix uteri].

Paraaortic lymph nodes involvement in patients with cervical carcinoma, even in less advanced stages, found in 100 cases examined, besides the data reported in literature, has driven the authors to locate, through the examination of lymphangiograms, the routes by which paraaortic metastases can occur. Authors pointed out different ways of invasion, besides the more common subsequent involvement going from pelvic to paraaortic nodes or from posterior channels that can lead to paraaortic spread without lesions in common iliac nodes. In detail lymphatic pathways have been opacified connecting distant nodal chains and finally external routes from external iliac lymph nodes directly to paraaortic chain.

Aorta↗

[Role of late laparotomy in Hodgkin's disease].

Between 1976 and 1986 42 restaging laparotomies (RL) were performed in patients with Hodgkin's disease (HD). Eleven patients had received only radiotherapy, 25 chemotherapy and 6 patients had received radiotherapy plus chemotherapy. Thirty-seven patients underwent RL because of the uncertain answer to therapy. In 17 cases the persistence of abdominal disease was suspected; in 20 patients, on the contrary, the RL was performed to confirm the clinical evaluation of complete remission (CR). In the first group 6 RL (35%) were positive, in the latter group in one case only (5%) evidence of disease was found. In the last 5 patients RL was performed for abdominal recurrence after a Relapse free Survival (RFS) of 60 months (range 25-110 months). RFS of pathologically evaluated patients is significantly higher than that of those clinically evaluated. The great number of false positive (65%) suggests a role of RL in avoiding any further therapy in patients having no clear signs of disease after treatment completion; thus permitting a lower incidence of complications such as: induced leukaemia, neoplasia and infertility.

Adolescent↗

Reeducative treatment of female genuine stress incontinence.

Three-months re-education treatment of genuine stress incontinence was given to 26 female outpatients: 22 patients completed the treatment programme and 4 interrupted it for various reasons. The aims of the treatment were both to correct compensatory habits that patients used to conceal or reduce leakage accidents and to give specific education and strengthening of pelvic floor muscles. All patients who completed the three-months treatment definitely improved and 7 were cured. Accordingly a marked reduction or absence of weekly incontinence episodes as well as a reduction of the daily frequency of micturition was observed. On vaginal palpation a clear-cut improvement of pubococcygeous muscle contractility was detectable. Urethral closure pressure profilometry showed significant improvement of functional urethral profile length at rest and of maximal urethral closure present both at rest and during maximal voluntary contraction of the pelvic floor muscles. Micturition cystourethrography, repeated in 15 patients at the end of the treatment, showed a clear-cut improvement of bladder neck suspension defects in all but 2 patients. Follow-up assessments showed that the clinical effects were long-lasting. Possible mechanisms of this re-educative technique are discussed.

Adult↗