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Biomedical subjects

C Brambilla

Publications and source records attributed to C Brambilla.

At least 253 records · Page 14Linked to original sources
PubMedDate not supplied

Comparison of two oral antibiotics, roxithromycin and amoxicillin plus clavulanic acid, in lower respiratory tract infections.

In a randomized, multicenter, open-label study, 490 ambulatory adult patients with lower respiratory tract infection (LRTI) were randomized to roxithromycin (ROX) 150 mg b.i.d. orally (n = 244) or amoxicillin plus clavulanic acid (AMX + CA) as 500 mg AMX + 125 mg CA t.i.d orally (n = 24). Clinical results were analyzed in 477 patients with acute bronchitis (79%), chronic bronchitis (CB) (14%), and pneumonia (7%). There were significantly more patients with underlying disease (cardiovascular diseases, p = 0.045; and alcoholism, (p less than 0.001), and more patients over the age of 65 years (p = 0.045) in the ROX group. Overall clinical efficacy was similar in both groups: 88% (206:235) in the ROX group and 85% (205:242) in the AMX + CA group. Side effects were reported in 67 cases (28%) in the AMX + CA group and in 21 cases (9%) in the ROX group (p less than 0.0001), causing withdrawal in 21 and three cases, respectively (p less than 0.001). Thus, despite being administered to a significantly older and more ill group of patients with LRTI, roxithromycin was as effective as amoxicillin plus clavulanic acid and better tolerated.

Acute Disease↗
PubMedDate not supplied

Bronchorrhea revealing cervix adenocarcinoma metastastic to the lung.

Copious bronchorrhea can be related to bronchioloalveolar carcinoma, but reports of bronchorrhea related to lung metastasis are rare. We report the case of a woman presenting lung metastases of a cervical adenocarcinoma revealed by bronchorrhea, eventually identified as ectopic cervical mucus. Treatment included anticancer drugs and erythromycin, the latter in order to reduce the bronchorrhea, with eventually poor efficacy. This observation illustrates the importance of respiratory signs in the post-therapeutic follow up of cancer, especially cough and bronchorrhea in adenocarcinoma.

Adenocarcinoma↗
PubMedDate not supplied

Activity and toxicity of 4'-iodo-4'-deoxydoxorubicin in patients with advanced breast cancer.

Based on our previous Phase I study indicating good tolerability of the drug, we have evaluated therapeutic activity and acute and subacute toxicities associated with repeated courses of the new anthracycline 4'-iodo-4'-deoxydoxorubicin (I-Dox) at the maximum tolerated dose (80 mg/m2) every three weeks. Thirty-three patients (31 evaluated for activity and 32 for toxicity) with relapsed (11 cases) or advanced breast cancer at presentation (22 cases) were treated with 108 cycles (median 3, range 1-7) for a median cumulative dose of 240 mg/m2. We observed no complete and 11 (35%) partial responses. Minor response was documented in 5 additional patients. The most frequent and severe toxicity was hematological. In 47% of the cycles and 34% of the patients I-Dox administration was associated with WHO grade 4 neutropenia. Severe neutropenia was more frequent after repeated cycles. Similar cumulative toxicity was observed for thrombocytopenia and anemia. In three patients (7 cycles) fever and possible infection occurred during neutropenia and required oral antibiotics. Extra-hematological side-effects were limited to mild/moderate nausea lasting for a few hours and mild fatigue lasting 1-7 days. Alopecia or oral mucositis were minimal or absent in the majority of patients. One case of potential reversible cardiac toxicity was observed after 240 mg/m2 I-Dox in a patient with preexistent cardiac risk factors. In view of the reported activity, good general tolerability, and selective hematological toxicity, I-Dox should be evaluated at higher than the conventionally defined maximum tolerated dose in combination with recombinant human hemopoietic growth factors.

Adult↗
PubMedDate not supplied

[The out-patient clinic for medical oncology treatment. Experience at the Istituto Nazionale Tumori of Milan (author's transl)].

The possibility to administer chemo-hormone- and immunotherapy on an out-patient basis has greatly increased because of the progress reached in the management of the out-patient departments. The improved knowledges on tossicological, pharmacodynamic and therapeutic data as well as the advent of the cyclic schedules determined the feasibility of medical treatments even when they are combined with surgical and/or radiotherapeutic modalities. To the patient, the possibility to be carefully and effectively treated on out-patient clinic, renders more acceptable, both from a psychologic and economic point of view, even a prolonged combined treatment. On the same time, also the Institutions have some advantages both on their organization (a shorter median stay in hospital and consequently a reduced waiting list) and for their scientific program (increased number of patients who can be treated according to a therapeutic program, possibilities to obtain statistically valuable information on the treatment program of a given disease and on the knowledge of its natural history). The last five year increasing activity of the Out-Patient Clinic for Medical Oncology Treatment of the Istituto Nazionale Tumori of Milan is illustrated in Text-figure 1, while Text-figure 2 represents its actual organization; this is obviously of a multidisciplinary type, both on its diagnostic and therapeutic phase. Table 1 shows the activity carried out in 1975; it is noteworthy that 2,570 patients have been followed, thus accounting for a total of 20,164 medical examinations and/or intravenous drug administrations. Table 2 presents the incidence of the different types of neoplasia followed in the out-patient department: the large majority was represented by breast cancer (40%); followed by malignant lymphomas (31.5%) and pediatric tumors (7.5%). During 1975, 22 therapeutic protocols have been applied, 10 of which (table 4) required an initial hospitalization and 12 (table 5) could be entirely carried out in the out-patient department. As shown in Table 6 chest x-rays accounted for 52% and skeletal survey for 18% of the 11.906 radiological examinations. Table 7 shows the number of off-hand required radiological reports carried out for patients not geographically accessible who, in one signle day, could have their radiological, and medical examinations as well as their hemogram and treatment performed. A total 467 scintiscans have been required, 86% of which of the liver (table 8). The hemato-pathology unit counted out about 16,000 hemograms with platelets (table 9). The hemograms were always performed within 1-2 hours with immediate communication of the counts to the out-patient department. In order to modify clinical situations which were deteriorated because either of the disease or of the treatment 358 blood units were transfused.

Academies and Institutes↗
PubMedDate not supplied

Amplification of oncogenes in lung carcinoma grafted in nude mice.

Seven lung carcinomas were grafted on nude mice and continuously propagated as in vivo models on which the amplification of 9 oncogenes (N-myc, v-erb A, v-abl, v-sis, c-myc, c-myb, v-Ha-ras, c-Kiras, and v-scr) was studied by Southern blot hybridization. Only c-myc was amplified (20 copies) in an adenocarcinoma. The presence of 2 bands at 9 kb and 6.6 kb in addition to the normal 12.7 kb in EcoR1 digested DNAs suggested a polymorphism of the c-myc gene in this tumor. The other 8 oncogenes were not amplified in this tumor. The 5 small cell lung carcinomas of this study did not show any amplification of any of the 9 oncogenes tested.

Adenocarcinoma↗
PubMedDate not supplied

Isoenzyme pattern of enolase in human lung tumor xenografts in nude mice.

A simple method is described which allows easy determination of neuroendocrine (NE) differentiation in human broncho-pulmonary tumor models grown in heterotransplanted nude mice. Enolase (EC 4.2.1.11) isoenzyme composition is studied using the electrophoretic method in xenograft tumor homogenates. The relatively large amount of alpha gamma and gamma gamma isoenzymes (neuron-specific enolase (NSE] is indicative of the neuroendocrine differentiation level of these tumors. The gamma gamma isoenzyme is present at a high level (M +/- SE: 10 +/- 2%) in all NE tumor models and absent in non NE tumor models. The alpha gamma isoenzyme is found in a significantly higher proportion in NE tumor models (30 +/- 2%) than in non NE tumor models (9 +/- 2%) (p less than 0.001). Moreover it is possible to discriminate between human and mice isoenzymes to estimate the proportion of mouse tissue hat is present in the xenograft.

Animals↗
PubMedDate not supplied

[Mediastinal lymph node extension in primary bronchial cancer: correlation of x-ray computed tomography, magnetic resonance imaging and mediastinoscopy. Apropos of 50 cases].

Based on a homogeneous series of 50 cases investigated within less than a week by CT scan and NMR imaging with mediastinoscopic correlation, and in 32 of theses cases with correlation with operative findings, a critical study was carried out of modern imaging methods for detection of mediastinal gland invasion from primary bronchial cancer. Axial mediastinoscopy presented absolute specificity and very high sensitivity (93%) markedly superior to those of CT scan and NMR imaging. The two latter examinations were practically of equal efficacy: sensitivity of NMR (80%) was somewhat higher than that of CT scan (70%) whereas specificity of CT scan was 83% as against 70% for NMR. Lack of efficacy of axial mediastinoscopy was in cases with extra-axial lymphatic extension (anterior mediastinal chains) from primary cancer. These results suggest that, in view of current inconveniences of NMR imaging, the best means for local and regional exploration of primary bronchial cancer preoperatively is combined CT scan and mediastinoscopy. The diagnosis of glandular enlargement of anterior mediastinal lymphatic chains should lead to performance of an anterolateral mediastinoscopy.

Aged↗
PubMedDate not supplied

[Tracheostomy for long-term ventilatory assistance. About 22 observations of severe chronic respiratory insufficiency (author's transl)].

22 patients with severe respiratory insufficiency were treated by definitive tracheostomy for intermittent ventilatory assistance. Early mortality is heavy (9/22 before three months). After three months, the respiratory condition of patients improved greatly and survival rate is good. Tracheostomy is too often delayed and realized at the bad time of a severe acute respiratory failure.

Adult↗