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Biomedical subjects

E Polli

Publications and source records attributed to E Polli.

At least 19 recordsLinked to original sources
PubMed1992

[The influence of the clinical course and diagnosis on the length of surgical stays].

The length of stay (LOS) is one of the major determinants of rising costs in surgical patient care. We studied the timing of the diagnostic procedures performed in 323 surgical patients admitted to 8 surgical departments of a large hospital. Of these: 50 underwent gastrectomy, 28 colectomy, 90 biliary tract (BT) operation, 94 appendectomy and 61 saphenectomy. The average total and preoperative LOS were respectively 27 and 11 days in the gastrectomy group, 26 and 10 in the colectomy group, 10 and 4 in the appendectomy group, 20 and 11 in the BT group, 12 and 6 in the saphenectomy group. The LOS was not affected by the presence of a benign or malignant lesion in gastrectomy and colectomy. In the appendectomy and BT groups, patients admitted from the emergency room had a significantly lower total LOS when compared to elective admissions (8 vs 12 and 9 vs 21 days respectively, p < 0.01). The multiple regression model showed that global and preoperative LOS were influenced by the number of instrumental exams (contrastographic, endoscopic, echographic).

Adolescent↗
PubMed1991

Analysis of diagnostic procedure costs for cerebrovascular disease admission to a highly specialized hospital.

Length of stay and hospital costs for cerebrovascular disease admissions depend on several hospital-, patient- and disease-related factors. To determine the incidence of each of these factors we studied 240 admissions for cerebrovascular diseases in a neurology division and in two medical divisions of a highly specialized hospital. Statistical analysis of the data collected from the case records revealed the effect of several factors. Some increased only the length of stay (severe neurological sequels on discharge; stay in general medicine, diagnosis of hemorrhage, arterial hypertension). Others increased investigation costs (length of stay, marital status), and costs were higher in a specialists ward. Length of stay was shorter where the nurse/bed ratio was higher. Old age and male sex were associated with a lower cost of diagnostic procedures.

Adult↗
PubMed1991

[The length of pre- and postoperative surgical stays. The role of factors relative to the patient, to the type of intervention and to hospital services].

The one-year most important and frequent surgical procedures performed in eight surgical departments of a large Italian general hospital were studied in order to describe the determinants of pre-, postoperative and total length of stay. The average length of stay (ALS) for the 724 hospitalized cases was 18.1 days (7.9 preoperative and 10.2 postoperative), with large variations in the preoperative ALS across the departments. Multiple regression analysis showed that total ALS was positively associated with age, type of surgical procedure and department of admission. Preoperative ALS was longer in intervention on colon (12 days) and stomach (11 days) than in saphenectomies (8 days) and in appendectomies (4 days). The degree of access to operating rooms was associated to preoperative ALS, while the type of intervention and age to postoperative ALS. ALS was reduced by the urgency of the case, the availability of diagnostic facilities in the department of admission and the patient's condition of student. Hospital's structure and organization need to be modified in order to reduce preoperative length of stay. The easier access of older patients to long-stay hospitals or home care would reduce postoperative length of stay.

Age Factors↗
PubMed1989

VMCP chemotherapy with or without interferon-alpha-2 in newly diagnosed patients with multiple myeloma.

Fifty-two previously untreated patients with multiple myeloma were randomized to either a combination of recombinant interferon (rIFN) alpha-2 and chemotherapy or chemotherapy alone. Patients were treated with vincristine, melphalan, cyclophosphamide and prednisolone every 4-6 weeks. In the combined treatment arm rIFN was administered concurrently with chemotherapy as well as during chemotherapy free intervals. The combined regimen effected 17/21 (80.9%) responses as compared to 19/27 (70.4%) responses in VMCP treated patients. Addition of rIFN to chemotherapy did not enhance hematologic toxicity. These findings suggest a somewhat higher rate of objective response in the VPMC + rIFN group, although a significant improvement in median survival by adding rIFN to conventional first line polychemotherapy in myeloma patients has not yet been achieved.

Adult↗
PubMed1989

Combined alpha-2C-interferon/VMCP polychemotherapy versus VMCP polychemotherapy as induction therapy in multiple myeloma: a prospective randomized trial.

Thirty-three previously untreated patients with multiple myeloma were randomized to either a combination of recombinant interferon-alpha-2C (rIFN-alpha-2C) plus vincristine/melphalan/cyclophosphamide and prednisone (VMCP) or VMCP chemotherapy alone. The combined regimen effected 67% responses and 26% minor responses, while 35 and 47% of VMCP-treated patients had a pathologically documented remission, respectively. Despite the somewhat earlier achievement and duration (12.0 vs. 8.0 months) of objective response, and the marginal survival benefit observed in the rIFN-alpha-2C + VMCP treatment arm, a significant improvement in therapeutic gain by adding a biologic response modifier to conventional first-line polychemotherapeutic drug treatment in myeloma patients has not yet been achieved. The combined regimen was well tolerated without unusual or unexpected toxic effects.

Adult↗
PubMed1988

CNS metastasis in ovarian cancer with microangiopathic hemolytic anemia associated with diffuse intravascular coagulation.

We present the case of a woman affected by ovarian cancer metastatic to multiple lymph node and the CNS. She was affected by hemorrhagic diathesis with microangiopathic alterations, whereas coagulopathy developed only after some days in coincidence with disease worsening. Our patient is probably one of those in which cancer leads to microangiopathy and coagulopathy by means of a tissue factor-like activity, a common event in mucin secretory tumors. Fibrinolytic activity was also increased in our patient as in others of the same type. The main aspect of this case report is metastasis to the CNS and to other multiple sites, which is quite uncommon in such cancers. We retain that tumor procoagulant activity could have played a role in this phenomenon.

Adenocarcinoma, Papillary↗
PubMed1988

Death from cardiovascular disease in Italy, 1972-1981: decline in mortality rates and possible causes.

Mortality rates for cardiovascular disease vary widely between countries, and epidemiological patterns (trends in incidence rates, prevalence of risk factors, availability of medical care) are heterogeneous even among industrialized nations. We studied mortality from cardiovascular disease in Italy from 1972 to 1981 and compared mortality to trends in risk factors during the same period. Age-adjusted mortality rates for acute ischaemic heart disease (IHD) have increased in Italy from 1972 to reach a peak in 1978 (180.53/100,000 in males, 51.55/100,000 in females), then declined between 1978 and 1981, by 7% in males and 5% in females. The decline was more evident in males and in the younger age groups. Deaths from chronic IHD reached a peak in 1973 in females and in 1975 in males, then decreased, respectively by 24.8% and 35.7% until 1981. Mortality for cerebrovascular disease declined from 1972 to 1981 by 16.2% in males and 21.5% in females. Data from national statistics and sample surveys in different areas of Italy show an increase in total calorie intake, in animal proteins, fats and dairy products and raised average serum cholesterol levels plus an increase in smoking prevalence but a possible decline in blood pressure levels. The roles of hypertension treatment and of access to specialized medical care are discussed as possible contributors to the new declining trend of IHD, and the need is stressed for preventive strategies in health promotion.

Adult↗
PubMed1988

Bioethics.

Explore the source record for details and available documents.

Bioethics↗
PubMed1987

Therapy with interferons in blood diseases.

We report the clinical experience gained with interferon treatment of B and T cell neoplasms, as well as of myeloproliferative and myelodysplastic syndromes.

Antineoplastic Agents↗
PubMed1987

Peripheral neuropathy in macroglobulinemia: incidence and antigen-specificity of M proteins.

Peripheral neuropathy was found in 12 (46%) of 26 patients with macroglobulinemia. The neuropathy was subclinical in two. Anti-myelin-associated glycoprotein (MAG) activity was found in six (50%) patients with neuropathy. Sural nerve biopsies showed demyelination and IgM deposits on the myelin sheath. In one patient who had no anti-MAG activity, the serum IgM bound to peripheral myelin by indirect immunofluorescence and to several protein bands in peripheral nerve and other tissues by immunoblot. In the other five patients with neuropathy, we found no binding of M proteins to nerve components, but in three patients there were endoneurial IgM deposits in nerve biopsy. Peripheral neuropathy may be related to the antigen-specificity of M proteins.

Adult↗
PubMed1986

Recombinant interferon alfa-2C versus polychemotherapy (VMCP) for treatment of multiple myeloma: a prospective randomized trial.

Forty-two previously untreated patients with multiple myeloma were entered in a prospective, randomised trial comparing recombinant interferon alfa-2C monotherapy with VMCP (vincristin, melphalan, cyclophosphamide and prednisolone). Both treatment arms were comparable for the stratification variables such as paraprotein type, stage of disease, and renal function. Rec. interferon effected 14% responses and 29% minor responses, while 57 and 32% of VMCP-treated patients achieved a pathologically documented remission (P less than 0.001). The time on initial treatment was significantly shorter in the IFN group (3.2 months) than in the VMCP group (7.6 months). In four patients in the IFN arm, primary treatment had to be changed according to progressive or severe stationary disease. Since all four patients responded to second line therapy (VMCP) no significant difference has been observed between the two groups in survival (median follow-up greater than 12 months). Despite this clear superiority of the conventional four-drug polychemotherapy, there was some suggestion that IFN might be particularly active in cases with low tumor-burden (stage I, II), and light-chain or IgA paraprotein type.

Adult↗
PubMed1986

Defective granulocyte chemotaxis and natural killer activity in a patient with recurrent infections.

A 25-year-old male with a history of recurrent infections presented with fever, severe aplastic anaemia, splenomegaly and retroperitoneal node enlargement. Lympho-histiocytic granulomas were found in spleen, liver and lymph nodes. Granulocyte studies revealed normal morphology, severely impaired random migration and complete absence of directed locomotion. Whereas phagocytosis was slightly reduced, candidacidal activity and nitroblue tetrazolium reduction were normal. Basal granulocyte cyclic GMP levels were within the normal range while a 5-fold increase of cyclic AMP levels was observed. Numerous abnormalities were also found in the patient's lymphocytes: lack of delayed hypersensitivity, reduced response to mitogens, low OKT4/OKT8 ratio, absence of natural killer (NK) activity with normal number of cells recognized by NK-specific monoclonal antibodies. These observations describe a distinct clinico-pathologic entity and suggest the possibility of a common defect in granulocytes and in NK cells.

Adult↗
PubMed1986

Cyclosporin A antileukemic activity: mode of action on target cells.

Cyclosporin A (CyA) is a potent immunosuppressive agent which has been reported to inhibit proliferation of human T leukemic lymphoblasts. We used the permanent cell line 8402 to perform a detailed investigation of the CyA mode of action on such cells. CyA treatment resulted in a dose-dependent inhibition of the 8402 cells growth rate which was paralleled by a decrease of tritiated thymidine uptake. These findings were the consequence of redistribution of treated cells in the cell cycle phase. By means of intracellular DNA content measurements made by flow cytometry, it was shown that the primary effect of CyA was accumulation of treated cells at the G1 phase of the cell cycle. At the doses used, CyA activity was not spontaneously reversible, resulting in death of treated cells which was apparent at about 72 h after exposure to the drug.

Cell Cycle↗
PubMed1985

Hypertension in man with a kidney transplant: role of familial versus other factors.

Genetic factors are clearly involved in the pathogenesis of essential hypertension in man. In at least three rat models of genetic hypertension it is possible to transplant the hypertension with the kidney. To see whether or not the same is true for humans, we carried out a 2-year retrospective study of 50 selected recipients of a cadaver kidney. We correlated the following factors by multivariate statistical analyses: presence or absence of hypertension in the family of donor and recipients; donor's and recipient's age; mean blood pressure (MBP) and antihypertensive therapy (AHT) score during dialysis; months of dialysis and body surface before transplantation; body weight, plasma creatinine, prednisone dosage and cumulative rejections with MBP and AHT score at various time intervals after transplantation. The results obtained showed that, considering the recipients coming from normotensive families, the AHT score after transplantation was significantly greater (p less than 0.05 1st and p less than 0.01 2nd year) in the patients receiving a kidney removed from donors with hypertensive families than in patients receiving a kidney removed from donors with normotensive families. This difference was not present when the recipients coming from hypertensive parents were considered. AHT score after transplantation is also correlated with AHT score on dialysis (p less than 0.01 1st and 2nd year), body weight (p less than 0.02 1st and p less than 0.01 2nd year), cumulative rejections (p less than 0.025 1st and 2nd year) and inverse MBP after dialysis (p less than 0.025 2nd year).

Adult↗
PubMed1985

Treatment with recombinant interferon-alpha-2C: multiple myeloma and thrombocythaemia in myeloproliferative diseases.

Forty-two patients with multiple myeloma were allocated to two groups to receive either polychemotherapy with vincristine, melphalan, cyclophosphamide and prednisolone, or recombinant interferon-alpha 2C monotherapy. The response rate of 43% in the interferon group was significantly lower than that in the chemotherapy group (89%). Patients with stage I disease showed better response rates than those with stage II or stage III disease. Eleven patients with thrombocythaemia due to polycythaemia vera, chronic myeloid leukaemia or essential thrombocythaemia were treated with recombinant interferon-alpha 2C and complete remissions were achieved in 7 of the 8 evaluable patients. Side-effects were common on interferon therapy, but could be reduced by dose reduction and were reversed by cessation of treatment.

Adult↗