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Biomedical subjects

D Moro

Publications and source records attributed to D Moro.

85 records · Page 5Linked to original sources

Sequential combination of 5-fluorouracil, cis-platinum and irradiation in unresectable non-small cell lung cancer.

Twenty patients with unresectable non-small cell lung carcinoma, 15 stage III and 5 stage IV (supraclavicular lymphadenopathy) were treated with a combination of three courses of chemotherapy and hypofractionated irradiation followed after 3 weeks by split-course radiotherapy. Each course was repeated every 3 weeks with the following sequence. Cis-platin (CDDP) (20 mg/m2) was given in a 20-min infusion, followed by a 2-h infusion of 5-fluorouracil (5-FU) (400 mg/m2) on days 1, 2, 5 and 6. Radiation with a dose of 3 Gy on the target volume was given on days 3 and 4, after a 2-h infusion of 5-FU (400 mg/m2). Split course of irradiation consisted of 16 Gy in 5 fractions repeated after 3 weeks interval. The objective response rate was 75%. Median follow-up was 24 months, the median survival was 14 months. The 1-year survival was 53% and the 2-year survival was 16%.

Actuarial Analysis↗

[Molecular analysis of biopsies of bronchial cancers: feasibility of a systematic approach].

Malignant cells can be distinguished from their normal counterpart at the DNA level: they carry molecular changes which are characteristic of the tumor type or which might have some prognostic value. Amplifications and mutations of oncogenes and loss of alleles have been reported to occur in lung cancers, but their prognostic value has not yet been estimated, mainly for technical reasons: primary fresh biopsies are usually too small for molecular investigation. From 79 biopsies (50 of which were obtained by fiberoptic bronchoscopy), DNA hybridization was performed using the Southern blot technique, with myc family genes probes and a polymorphic probe located on the short arm of chromosome 3. Our study indicates that: 1) in 88% cases, enough DNA can be obtained by 3 or 4 fiberoptic bronchoscopy biopsies: from 5 to 80 micrograms DNA with an average of 25; 2) the quality of DNA is good for analysis by the Southern blot technique; 3) the loss of allele on chromosome 3 (3p 14-23) can be detected both in the small cell and in the non small cell type, but contamination of the specimens by non-tumoral tissue (based on the cytological and histological analysis of each biopsy) remains a problem for this type of study; 4) gene amplifications and rearrangements can be easily evaluated for the genes of the myc family. This pilot study shows that DNA analysis is feasible on perendoscopic biopsies. Collection and analysis of a large series of such biopsies at diagnosis is essential to define the value of DNA markers as prognostic factors in lung cancers.

Alleles↗

[A case of pleuropneumopathy due to Eikenella corrodens].

We report the observation of a pleuropneumonia due to Eikenella corrodens in a man of 39 years old suffering from diffuse dilatation of the bronchi. This small micro-aerophilic Gram negative bacillus has rarely been implicated as a cause of pneumonia. It appears that it may often be associated with streptococcal infections and that it becomes a pathogen when the immunity is lowered. Its sensitivity to antibiotics is excellent, particularly vis-à-vis bêta-lactams.

Adult↗

[Primary pulmonary malignant fibrohistiocytoma. Apropos of a case].

A case of primary malignant fibrous histiocytoma of the lung is reported. The clinical course was divided into 2 periods: slow tumoral growth followed by rapid aggravation. The pathological aspects of the first localization and of the relapse are analyzed and discussed. Data from the literature are reviewed, with special attention to diagnostic and prognostic problems.

Adult↗

The luteal phase after hyperstimulation for in vitro fertilization.

Of 500 cycles in which in vitro fertilization (IVF) was undertaken, laparoscopy was performed 372 times, 272 embryo transfers were carried out, and 55 pregnancies resulted, 30 of which resulted in delivery. Of those patients who underwent laparoscopy, 156 received clomiphene citrate alone, 203 clomiphene citrate and hMG, and 13 hMG alone. All patients were found to have a luteal-phase length of 10 days or greater (measured from the time of ovulation). The midluteal urinary total estrogen (UTE) value and pregnanediol excretion (Pd2) far exceeded the levels seen in normal cycles. There were no significant differences between conceptual and nonconceptual cycles and the high levels encountered would be expected after deliberate hyperstimulation. Fifty-five patients (in whom 11 pregnancies resulted) were monitored every other day throughout the luteal phase after embryo transfer. Both conceptual and nonceptual cycles showed a peak in pregnanediol glucuronide level around luteal day 6, which then fell. The level rose again if the corpus luteum was "rescued" by the implanting embryo. While the difference was not statistically significant, the estradiol levels appeared to decrease earlier in the nonconceptual cycles than in the continuing pregnancy cycles. It is important to note that the pattern of steroid production in the follicular phase was similar in both conceptual and nonconceptual cycles. While these data are not conclusive, they suggest that some nonconceptual cycles may have suffered early corpus luteal regression. Whether luteal-phase support is indicated in patients treated with clomiphene or clomiphene/hMG therapy cannot be determined from this study. However, it is thought that a controlled study of luteal-phase support in patients so stimulated is warranted. It appears that patients treated with hMG alone tend to undergo a compressed cycle and should be given luteal-phase support since other studies have reported shortened luteal phases following such hMG therapy.

Chorionic Gonadotropin↗

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↗

Assessment of the current status of iodine prophylaxis in Bosnia and Herzegovina Federation.

Assessment of the status of iodine prophylaxis was studied in 5,523 schoolchildren randomly selected in all cantons in Bosnia and Herzegovina Federation (BHF). According to the iodine content of household salt samples, all cantons of BHF were divided into two groups: Group A: 95.5% of the salt used is produced in the Tuzla plant, in which the salt is iodized at 5-15 mg KI/kg salt, and 4.5% of the salt used is produced in the Pag plant, in which the salt is iodized at 20-30 mg KI/kg of salt, and Group B: 19.9% of the salt used is produced in the Tuzla plant and 80.1% in the Pag plant. In Group A the amount of iodine in salt was significantly lower than in Group B (11.4 mg/kg vs 18.9 mg/kg, P < 0.001). In Group A the prevalence of goiter was significantly higher than in Group B (32.6% vs 19.7%, P < 0.001). The highest prevalence of goiter was in Bosnian Podrinje Canton (51.2%) and Central Bosnian Canton (42.6%) while the lowest was in West Herzegovina Canton (12.9%). Significantly higher concentrations of urinary iodine were found in Group B than in Group A (82.6 microg/l vs 75.2 microg/l, P < 0.001). In Group A the percentage of urine samples below 50 microg/l iodine was significantly higher than in Group B (35.6% vs 26.9%, P < 0.001), but there was no difference in the percentage of urine samples with iodine values less than 100 microg/l (70.7 microg/l vs 68.25 microg/l, P > 0.05). We conclude that FBH is an iodine deficient area and that the improvement of iodine prophylaxis is urgently required, primarily by increasing salt iodine content to 20-30 mg/kg, in order to eradicate endemic goiter.

Adolescent↗

[The TRH test in Turner syndrome].

In order to evaluate the functionality of the hypothalamic-hypophyseal-thyroid axis in Turner's syndrome (TS), 27 subjects, aged between 5.1 and 16.1 years old, were studied, 14 of whom were karyotype 45,XO and 13 affected by mosaicism. The TRH test (200 mcg i.v.) was performed in all subjects using a single bolus. TRH titers were assayed in serum samples collected at 0, 15, 30, 60 and 90 minutes, and anti-microsome and anti-thyroglobulin, T4 and T3, were assayed in the basal sample; the latter were also assayed in the blood sample collected at 120 minutes. These results were compared with those obtained using the same test in a group of age- and sex-matched controls. Anti-thyroid antibodies and basal levels of T3 and T4 were within the norm in 26 subjects; a high basal value of TSH was only found in one patient with chromosomic mosaicism with an elevated response to TRH and a high titer of anti-microsomic antibodies. Apart from this no statistically significant differences were found in patients compared to control subjects in relation to TSH values at all stages of the test and between the two groups of TS; no significant results were found in the comparison between the areas below the curves (AUC). On the basis of these results the Authors conclude that it is not possible to reveal alterations in thyroid function attributable to hypothalamic and hypophyseal anomalies in this group of patients either with karyotype 45,XO and mosaicism.

Adolescent↗

Small cell lung cancer: patients surviving longer than thirty months. Groupe d'oncologie de langue française.

The long-term survivors of SCLC are described in 3 different types of study: analysis of prognostic factors of phase II and III chemotherapy trials (3,4,5,6,7,17,18), epidemiological studies (8) and medical registries of LTS (9,10). A small number of patients with small cell lung cancer achieve long-term survival. Most of these patients have a disease limited to the chest at the time of diagnosis. The major concerns of these LTSs are: the relapse of the SCLC, the occurrence of a second primary tumour and the occurrence of a disease related to tobacco consumption. About 20% of the LTSs die of non-cancer related causes and this exceeds the age adjusted mortality. There is a high risk of relapse in the first 4 years after the diagnosis; this risk decreases later, but relapses may be seen until 7 years. Nearly 8% of LTSs developed a SPTs are alive at 8 years; this indicates that cure is possible in SCLC, however, these patients account for less than 3% of the overall population.

Aged↗