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Biomedical subjects

E Ferrazzi

Publications and source records attributed to E Ferrazzi.

At least 91 records · Page 5Linked to original sources

Variability analysis of fetal heart rate signals as obtained from abdominal electrocardiographic recordings.

The present paper introduces an original method of digital signal processing for an automatic analysis of non-invasive abdominal ECG recordings on pregnant women starting from the 25th week of gestation. The procedure has been implemented on a DEC-VAX 750 digital computer at the Department of Electrical Engineering, Polytechnic of Milano and the signals are recorded at the Department of Obstetrics and Gynecology "L. Mangiagalli", University of Milano, Italy. The experimental results presented in here are still preliminary as only few cases have been considered up to now (about 20) and the goal of the paper is mainly focused on the algorithmic aspects of the whole procedure implemented in the computer and on the approach of heart rate variability (HRV) signal analysis both in the mother and in the fetus. Abdominal ECG lead processing is illustrated starting from the step of maternal (M) and fetal (F) QRS recognitions through linear digital filtering (derivative and low-pass FIR filter, Weber-Cappellini window) and weighted averaging techniques synchronized with maternal QRS's. Figure 1 a shows the original abdominal lead; figure 1 b the filtered signal for MQRS recognitions; figure 2 a the template of maternal cardiac cycle as obtained after the averaging operation synchronized with the instants of MQRS occurrence. The subtraction of the template results in the abdominal lead shown in figure 1 c in which the contribution of MECG is practically entirely reduced even in the case of MQRS and FQRS overlapping.(ABSTRACT TRUNCATED AT 250 WORDS)

Electrocardiography↗

The clinical relevance of the abdominal fetal electrocardiogram.

We investigated the duration of fetal electrocardiographic events during normal pregnancies and during pregnancies with fetal abnormalities. The fetal abdominal signal was processed and enhanced by means of the averaging technique after removing the maternal complex. In normal pregnancies P wave and QRS complex duration increases progressively from the 17th week up to the term: this increase parallels the gain in weight of the fetal heart and particularly of the ventricular mass. These results indicated that the duration of fetal complexes could be used as an index of the size, development and maturity of the fetal heart. When fetal growth retardation (FGR) is present, the weight of the fetal heart is significantly reduced, and is reflected in a decrease in QRS duration. In a series of 107 cases the sensitivity of this parameter in detecting FGR was 81% and the specificity 93%. Moreover no perinatal death nor Apgar values below 7 occurred in growth retarded fetuses with normal QRS duration, while in the group with shortened QRS neonatal deaths were 11% and Apgar scores below 7 26%. Abdominal FECG do provide important auxiliary information for prenatal diagnosis of congenital heart defects (CHD). Anomalies with abnormal atrioventricular connection were reflected in longer PR interval. Ventricular hypertrophia and hypoplasia were associated with increased or decreased QRS duration, respectively. Furthermore, the three fetuses which developed congestive heart failure showed prolonged QRS duration. In severe RH disease, chronic fetal anemia can lead to myocardial hypertrophy and cardiac enlargement.(ABSTRACT TRUNCATED AT 250 WORDS)

Electrocardiography↗

Antitumor activity of new anthraquinone derivatives.

Seven new 9,10-anthracenedione derivatives bearing positively-charged side chains at different positions of the condensed ring system have been investigated in their interaction with DNA and their biological effects, including antitumor activity in the P 388 mouse miniscreen. The drug's affinity for DNA was found to be related to the efficacy of inhibition of cell growth and nucleic acid synthesis for a number of cell lines. Moreover, alkaline elution experiments showed a close relationship between mutagenic potential and cytotoxicity. With the exception of one, all compounds behaved like intercalating agents, as shown by the unwinding of supercoiled plasmid DNA. DNA appeared, therefore, to be the more important target for drug action. The marginal in vivo activity shown by two substances in this series suggests a number of possible structural modifications which may increase their therapeutic efficacy.

Animals↗

Lipid bound sialic acid in cancer patients.

Serum lipid-bound sialic acid (LSA) was measured with a recently described procedure in 108 healthy subjects and in 138 patients with a variety of solid tumors and hematologic malignancies. At the time of serum sampling, 128 patients had active disease and 10 patients had no evidence of disease. LSA was elevated in 104 of 128 (81.2%) patients with active disease, while carcinoembryonic antigen, analyzed in 74, was elevated only in 21 (28.4%) (P less than 0.05). Sensitivity of the serum LSA test ranged from 66% for breast and gastrointestinal cancer to 92% for lung cancer. In patients with lung cancer, ovarian cancer or Hodgkin's disease, LSA was correlated with the extent of disease and it also proved to be useful in following the course of disease. Our preliminary data indicate that this test can be used as a monitor of tumor burden.

Breast Neoplasms↗

Aminoglutethimide and estrogenic stimulation before chemotherapy for treatment of advanced breast cancer. Preliminary results of a phase II study conducted by the E.O.R.T.C. Breast Cancer Cooperative Group.

While both endocrine therapy and chemotherapy are of proven value in the treatment of advanced breast cancer, the effects of combining these two methods or applying them consecutively have been relatively disappointing. This may be due to endocrine therapy suppressing cell division, in hormone-dependent tumors, whereas chemotherapy acts mainly on active-dividing cells. A trial protocol has therefore been devised which seeks to exploit the properties of both types of therapy. Oestrogen suppression is first obtained by aminoglutethimide (Orimeten) plus hydrocortisone; after 2 weeks, ethinyloestradiol is given to induce cell division and followed 24 h later by a combination of 3 cytotoxic agents given intravenously. This pattern of therapy, repeated at regular intervals, appears to be producing favorable clinical results. A phase-III study is being started among patients with hormone-dependent advanced breast cancer.

Adult↗

First trimester fetal diagnosis of genetic disorders: clinical evaluation of 250 cases.

Chromosome and enzyme determinations were performed in 250 pregnancies between the 7th and the 12th week of gestation. The majority of the tests were performed for risk of chromosomal abnormalities and 75% of the women were 35 years old or more. We describe a chorionic villi sampling (CVS) technique which proved to be highly efficient, with a diagnostic success rate of 97.7%. In the light of our experience we suggest that CVS is best performed between the 9th and 10th weeks of pregnancy. The average weight of the aspirated specimen was 20 mg with a lower limit of 5 mg which proved sufficient for diagnostic purposes. No major maternal complications were encountered and the slight bleeding observed in 14% of the cases during the days following the CVS should be considered a harmless effect of the aspiration technique. The proportion of fetal losses may lie between 4 and 7%. Paediatric monitoring of the 93 infants born so far and ultrasound examination of the pregnancies still in progress at the time of writing did not reveal any negative effect of CVS. Fetal-maternal transfusion and intrauterine infection are problems which need further basic investigations.

Adult↗

Validity and limitations of ultrasonography in monitoring therapeutic response in ovarian carcinoma.

The effectiveness of ultrasound in the follow-up of tumor masses during chemotherapy was investigated over a period of 3 years in 74 patients with proven ovarian cancer. 47 had stage 3 disease, and 22 showed recurrence. Two or more examinations were performed in 65% of the patient. A correlation with surgical second look showed a correct diagnosis in 67.6%. The results of ultrasonographic follow-up when compared with clinical monitoring showed 75% concordant judgments on the therapeutical tumor response. The validity and limitations of this technique are discussed.

Evaluation Studies as Topic↗

The contribution of sonographic evaluation of ovarian size in patients with polycystic ovarian disease.

The ovarian size of 44 patients with clinical and endocrinologic findings suggesting polycystic ovarian disease (PCOD) was studied by ultrasound examination. Reproducibility of the ovarian parameters (transverse, longitudinal, and anteroposterior diameters, and volume) was also evaluated. The endocrine status of each patient was evaluated by assay of blood levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, 17 beta-estradiol (17 beta E2), and serum prolactin (PRL). Ovarian size was also investigated in 40 women with normal cycles, following the same ultrasound procedure. The mean ovarian volume of the normal controls was statistically different from the mean of patients with PCOD. Only 34 per cent of the patients affected by PCOD were above the second standard deviation of normal ovarian size. A correlation between endocrinologic findings and ovarian size was observed in women whose ovarian size fell within normal limits; these women had higher, though not statistically different, values of LH and testosterone and lower values of 17 beta E2 and PRL compared with patients with enlarged ovaries. Responsiveness to treatment was more easily observed in patients with ovarian enlargement.

Adolescent↗

Phase II evaluation of 4'epi-doxorubicin in patients with metastatic colorectal carcinoma.

Thirty-four evaluable patients with metastatic colorectal carcinoma (13 rectal primary and 21 colonic primary, 4 pretreated and 30 untreated) received 4'epi-doxorubicin at the dose of 75 mg/m2 i.v. once every 21 days, for a minimum of 2 courses. Symptomatic toxicity (mainly confined to gastrointestinal complaints) was short-lived and easily managed. Hematologic toxicity was mild. Transient electrocardiographic abnormalities were found in 50% of patients, without signs of significant cumulative cardiotoxicity. Three previously untreated patients achieved a partial response (lasting 16, 12 and 12 weeks, respectively) with a response rate of 9% (3%-23%, 95% confidence interval). More interestingly, all responsive patients had rectal cancer: further studies of 4'epi-doxorubicin confined to the rectal localization seem warranted.

Adult↗

Perinatal ultrasound monitoring: early detection and treatment of congenital uropathy.

In childhood, delay in the diagnosis of congenital obstructive or refluxing urinary tract pathology can contribute to progressive renal failure. Ultrasound examination is a safe and reliable means of investigating the urinary system pre- and post-natally. We describe 13 children investigated with ultrasound during the perinatal period. In 10, pathology was identified in utero, confirmed after birth and treated surgically within 1 month. This indicates that perinatal ultrasonography is a valuable technique.

Constriction, Pathologic↗

Cis-dichlorodiammineplatinum (II), VP 16-213, and prednisone (DVP regimen) in the treatment of pretreated advanced malignant lymphomas.

Eighteen evaluable patients with advanced malignant lymphoma were treated with a combination of cis-dichlorodiammineplatinum (II) (50 mg/m2 i.v. on day 1), VP 16-213 (100 mg/m2 i.v. on days 1, 3, 5), and prednisone (50 mg/m2 per os on days 1-5), recycling every 2 weeks. All patients were previously pretreated. There were 3 complete remissions (patients with Hodgkin's disease), and 4 partial remission (2 patients with Hodgkin's and 2 with non-Hodgkin's lymphoma), for a median duration of 8 weeks. In addition, 2 minor responses (patients with Hodgkin's disease) were observed. Vomiting and myelosuppression were the most prominent toxic effects. In most heavily pretreated patients, myelosuppression was moderate to severe: in these patients and in patients with bone marrow involvement, a schedule interval of 3 weeks should be more appropriate. Nephrotoxicity was minimal. This combination chemotherapy showed some activity in the management of advanced malignant lymphomas; further studies in this area are justified.

Adult↗

Vindesine in the treatment of squamous cell carcinoma (WHO I), adenocarcinoma (WHO III), and large cell carcinoma (WHO IV) of the lung.

The antineoplastic activity of vindesine was evaluated in 57 patients with non-small-cell carcinoma of the lung, 53 patients were fully evaluable for response and toxicity. Twenty-seven patients had squamous cell carcinoma (WHO I), 14 had adenocarcinoma (WHO III), and 12 had large cell carcinoma (WHO IV). Forty percent of patients were previously treated. Vindesine was administered at a weekly i.v. dose of 3 mg/m2. Partial remissions were observed in 2 of 12 patients with large cell carcinoma and in 1 of 27 patients with squamous cell carcinoma. Among 14 patients with adenocarcinoma, 3 minor responses were observed. Drug-related toxic effects (mainly leukopenia with manageable and reversible neurotoxicity) required modification of dose in 41% of patients: this finding and previous treatment may have adversely affected the response rate. It is concluded that vindesine as a single agent has some activity in large cell carcinoma. Activity in the other histologic types was minimal but not totally absent and deserves further evaluation, possibly in non-pretreated patients.

Adenocarcinoma↗

Phase II study of 4'epi-doxorubicin.

Sixty-five patients with advanced solid tumors were treated with 4'epi-doxorubicin, a new analogue of doxorubicin (DXR). Forty-three of 61 evaluable patients had not received previous chemotherapy and/or hormonal treatment. 4'Epi-doxorubicin has been administered at the dose of 75 mg/m2 i.v. once every 21 days, for a minimum of 2 courses. The pattern of acute toxicity was similar to that of DXR. Transient electrocardiographic abnormalities were found in about 50% of patients. The ratio of pre-ejection period to the left ventricular ejection time (PEP/LVET) increased within 1 h after drug injection and returned to near basal values after 24 h. Three patients received a total dose of more than 550 mg/m2, still maintaining a baseline PEP/LVET ratio near to pretreatment values. Up to now, no patient has developed clinical signs of heart failure. Partial responses were seen in patients with tumors generally sensitive to DXR such as breast carcinoma (6 of 14) and soft tissue sarcomas (2 of 6), and in patients with tumors generally resistant to DXR such as melanoma (1 of 9), colorectal carcinoma (3 of 18) and pancreatic carcinoma (1 of 2). These data suggest that 4'epi-doxorubicin may have a broader spectrum of antitumor activity than DXR.

Adult↗

Difficulties in "real-time" ultrasound diagnosis of fetal urological anomalies.

In the fetus of a diabetic woman, at the 24th week of pregnancy urological anomalies (cystic kidney malformations) were found with real-time ultrasound. At the 34th week these findings were confirmed and interpreted to be due to a lower urinary obstruction. Therefore a preterm Caesarean section was performed. In the newborn the left multicystic kidney was removed. The indications for the US screening in pregnancy and difficulties in the interpretation of urological findings of fetal and newborn ultrasonograms are discussed.

Female↗