Fulminant onset of spontaneous bacterial peritonitis.
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Acute Disease↗
Biomedical subjects
E Villa
Publications and source records attributed to E Villa.
Susceptibility of chronic symptomless HBsAg carriers to ethanol-induced hepatic damage.
To investigate the susceptibility of chronic symptomless HBsAg carriers to the hepatotoxic effect of ethanol 296 such carriers were followed up for 3 1/2 years with repeated biochemical and clinical examinations. A control group of HBsAg-negative blood donors matched by age, sex, occupation, duration and type of ethanol intake, and state of nutrition were followed up for the same period. Chronic symptomless HBsAg carriers seemed to be at risk of hepatic abnormalities when drinking an amount of ethanol which was harmless for HBsAg-negative subjects (less than 80 g). It may therefore be advisable to suggest complete abstinence from ethanol for HBsAg carriers.
Alcohol Drinking↗
[Organization of a patient's file of a radio-chemo-therapy department by means of a mini-computer (author's transl)].
The clinical research in the oncological field makes it necessary to have in the shortest possible time information as to the statistical elements of the various neoplasias according to the adopted treatment schemes. In this report we are going to describe the realization of a computerized file with the patient's data of our radio-chemo-therapy department. From the clinical report of each patient, according to the physician's judgement, the more important medical and anagraphical data have been taken out to be then memorized in the computer. The analysis of the data introduced allows to obtain an inventory of patients in alphabetical order, according to the type of neoplasia and to the type of the treatment. The system is quite easy to be used and the interaction with the user is dialogue oriented. In this way both the inserting and the research stage of the filing data as well as the printing of the lists can be effected even by people not particularly trained in the computer use.
Computers↗
The accumulation of 2-deoxyglucose-6-phosphate activates glycogen synthase (and inactivates glycogen phosphorylase) in rat skeletal muscle.
In the muscle loaded with 2-dGlc "in vitro" (this sugar is accumulated as hexosephosphate) glycogen synthase I levels are changed by a mechanism which is additive to those of hormones such as insulinor epinephrine. The levels of glycogen phosphorylase are decreased only at the highest 2-dGlc-6-P concentration. The role of this effect of sugar phosphate - which has been attributed to the activation of muscle phosphatase (6) - is discussed with regard to glycogen metabolism during muscle function.
Animals↗
Prospective study with HEXA-CAF combination in ovarian carcinoma.
The value of combination chemotherapy with HEXA-CAF was analyzed in 31 patients with histologically documented epithelial ovarian cancer in advanced stages (minimal or gross disease). No patient had been previously treated with chemotherapy. Peritoneoscopy with diaphragmatic inspection, peritoneal cytology, lymphography, and chest X-ray were routinely used in staging and restaging the patients. Complete (CR) plus partial (PR) responses were obtained in 13/31 fully restaged patients (41.9%). CR was recorded in seven patients (22.5%) and PR in six patients (19.3%). Remission duration was significantly longer in patients who achieved CR (20 months) than in those who attained PR (9.5 months) (P Less Than 0.01). In all treated patients the median duration of survival was 16.5 months. Survival was significantly longer in patients with CR than in patients who did not achieve CR (P Less Than 0.05). Nevertheless, considering the rate of CR in patients with gross disease (20.6%), HEXA-CAF combination seems a useful but not yet a hopeful treatment for patients with advanced ovarian carcinoma.
Altretamine↗
Study of the long-term effects of selective biliary obstruction (SBO).
Selective biliary obstruction (SBO) is a model of partial cholestasis in the rat in which the bile duct draining the median lobe is ligated and transected; the remaining biliary tree remains intact. Other authors introduced this experimental model and studied morphological and biochemical modifications in the liver after 2 days from surgery. They suggest that an adaptation may occur. Choosing some markers of cholestasis and some other markers of various cytoplasmic organelles, we studied the long-term effects that occur in serum and in total liver homogenate of selectively obstructed rats as compared to controls. Alkaline phosphatase activity and bile acids content, which were significantly higher than controls in serum and in total liver homogenate of the median lobe after 2 and 8 days from SBO, returned to normal range values after 30 days. Cytochrome-oxidase and glucose-6-phosphatase activity in total homogenate of the SBO median lobe remains perfectly similar to the control values in time. Results, together with morphological observations, suggest that cholestasis is present immediately after operation, then decreases gradually and disappears finally. The obstructed median lobe seems to cope with cholestasis.
Alkaline Phosphatase↗
Hepatitis B virus markers on dried blood spots. A new tool for epidemiological research.
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Epidemiologic Methods↗
Labeling index as a prognostic marker in non-Hodgkin's lymphomas.
The labeling index (LI) was determined at the time of initial diagnosis of 88 untreated adults with non-Hodgkin's lymphomas. The frequency distribution of low (less than or equal to 4%) and high (> 4%) LI between tumors with nodular and diffuse histologic patterns was significantly different (P < 0.001): The median LI was about four times greater for diffuse lymphomas than for nodular lymphomas. LI was not correlated with either disease extent or systemic symptoms. In patients with tumors of low LI, complete remission occurred in 86% of those with modular lymphomas and in 74% of those with diffuse lymphomas. These values were significantly different from the 17 and 39% observed respectively for nodular and diffuse lymphomas with high LI. Patients with low LI had greater actuarial 4-year survival than did those with high LI (P < 10(-7)). Highly significant differences between the two kinetic groups were also observed within nodular and diffuse patterns. However, whereas the difference for nodular lymphomas was independent of histologic subtype and stage, this was not always true for all subtypes of diffuse lymphomas. LI could be a useful marker to identify prior to treatment the patients who could enter complete remission and have favorable survival. Its clinical relevance as a prognostic factor appeared superior to the Rappaport histologic classification and pathologic stage, especially in patients with nodular histology.
Actuarial Analysis↗
Reactivation of hepatitis B virus infection in two patients: immunofluorescence studies of liver tissue.
Two patients, 1 with chronic active hepatitis, the other with Goodpasture's syndrome, became HBsAg-positive after the start of immunosuppressive drug therapy. At the same time of presentation, sera contained anti-HBc antibodies of IgM and IgG class in the absence of HBsAg or anti-HBs and immunofluorescent studies of liver biopsy specimens showed core antigen in the nuclei of liver cells. It is suggested that these findings reflected an unusual pattern of hepatitis B virus infection with a very low level of viral replication and that the appearance of HBsAg in both serum and liver cells after immunosuppressive drug therapy was due to reactivation of this infection, possibly as a result of changes in levels of antibodies which suppress viral replication. In 1 patients, the change in viral replication was associated with continuing liver cell necrosis and progressive deterioration in liver function.
Anti-Glomerular Basement Membrane Disease↗
Evidence for hepatitis B and other virus infection in HBsAg-negative chronic active hepatitis.
Antibody to the hepatitis B core antigen (anti-HBc) was detected in sera from 6 (19%) of 32 patients with HBsAg-negative chronic active hepatitis. In three cases with the highest anti-HBc titers, core antigen was detected in liver cell nuclei and in one case HBsAg was also present in hepatocytes, suggesting continuing hepatitis B virus infection. During follow-up, anti-HBc titers fell slowly in those with no viral antigens in liver tissue, and in two cases with virus in the liver at presentation, viral antigens were no longer demonstrable four and eight years later. In one case, clearance of virus was preceded by the appearance of HBsAg in liver and serum, suggesting reactivation of viral replication. In three of the anti-HBc-negative cases a nuclear antigen unrelated to the hepatitis B virus was detected by immunofluorescence, and it is possible that liver disease in these patients may be related to persistent non-A, non-B virus infection.
Adult↗
Adriamycin cardiotoxicity: a survey of 1273 patients.
Valuable information was collected on the medical history and clinical course of 1273 patients entered in clinical trials with Adriamycin (ADR) carried out in 12 European cancer centers. A coded patient form was used for the data collection carried out in each center by a qualified physician following a guideline which was discussed and accepted by all of the participants. The aim of the study was to define the incidence, characteristics, and possible co-factors of the cardiomyopathy (CMP) in patients treated with combination chemotherapy regimens including ADR. The mean total dose of ADR was 268 mg/m2 (range, 15--1251 mg/m2), and 5.1% of the patients received a total dose of greater than 550 mg/m2. A "definite" ADR-related CMP was observed in 1.7% of the cases; another 3% of the cases were reported as "possible" ADR-CMP since the role played by the drug could not be clearly defined. "Definite" ADR-CMP was fatal in eight patients (0.6%) while "possible" ADR-CMP was fatal in 13 patients (1.0%). Among the possible co-factors examined, the following ones were found to be significantly associated with the occurrence of a "definite" ADR-CMP: (a) total dose of ADR; (b) vincristine when given both before and concomitantly with ADR; (c) bleomycin when given before ADR; and (d) radiotherapy to the mediastinum when given concomitantly with ADR. Furthermore, none of 182 patients receiving ADR by slow infusion developed a "definite" ADR-CMP, while 2% of the patients treated by bolus injection did so. The occurrence of a "possible" ADR-CMP was found to be significantly associated with two pre-existing pathologic conditions (electrocardiogram [ECG] abnormalities and hypertension) but not with the treatment-related co-factors for the "definite" ADR-CMP mentioned above. Other variables examined, such as sex, age, cancer type, baseline liver function, and cyclophosphamide treatment, did not seem to influence the risk of ADR-CMP. Data on ECG changes occurring during ADR treatment were also reported and their incidence was found to be strictly related to the frequency of the ECG monitoring.
Adolescent↗
[Medical treatment of hemorrhoidal varices: comparison of treatments].
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Adrenochrome↗
Cyclophosphamide, vincristine, and prednisone (CVP) versus adriamycin, bleomycin, and prednisone (ABP) in stage IV non-Hodgkin's lymphomas.
In stage IV non-Hodgkin's lymphomas, CVP (cyclophosphamide, vincristine, and prednisone) was randomly compared to ABP (adriamycin, bleomycin, and prednisone). Of 62 patients entered into the study, 57 (CVP 27, ABP 30) were considered evaluable for comparison. In patients with liver and/or marrow involvement a second biopsy was performed to define complete remission (CR). CR occurred in 48% of patients treated with CVP and in 50% of those given ABP. The median duration of CR was 10.5 and 20.5 months, respectively. The difference is not statistically significant. Also, the survival of complete responders was not significantly different between the two treatment groups. After cross-over, secondary treatment with CVP produced an overall response rate of 40% (six of 15), compared to 50% (six of 12) obtained with ABP. In the ABP group, four patients developed a reversible interstitial penumonia. In two other patients, cardiomyopathy (fatal in one) was observed. In conclusion, although complete remission was similar in both groups, cumulative toxicity occurred in few patients given ABP. However, this combination could represent an effective alternative treatment to be used either in CVP failures or sequence with CVP.
Adolescent↗
Non-cross-resistant combinations in stage IV non-Hodgkin's lymphomas.
Two triple-drug combinations (cyclophosphamide, vincristine, and prednisone [CVP] and adriamycin, bleomycin, and prednisone [ABP]) were randomly tested in 57 consecutive patients with pathologic stage IV non-Hodgkin's lymphoma. No statistical difference was observed in the incidence of complete remission (CR) (48% vs 50%), median duration of CR (10.5 vs 20.5 months), and survival. CR correlated positively with survival. After crossover for progression or relapse, no cross resistance was detected between the two combinations (CR plus PR = 40% for CVP and 50% for ABP). In a subsequent prospective study CVP and ABP were sequentially alternated in an attempt to improve the incidence and duration of CR. In the first 32 evaluable patients CR was produced in 50%. The findings are still preliminary.
Adolescent↗
[Clinical trials of a syrup, C 1561, in respiratory diseases in children].
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Anti-Inflammatory Agents↗
Ethanol-induced increase in cytosolic estrogen receptors in human male liver: a possible explanation for biochemical feminization in chronic liver disease due to alcohol.
The hepatic cytosolic estrogen receptor content was measured in liver samples from patients with normal livers and from patients with nonalcoholic cirrhosis, alcoholic cirrhosis and alcoholic hepatitis. The estrogen receptor content of normal liver was 5.2 +/- 3.5 fmoles per mg of cytosolic protein. Levels which were not significantly different from this were found in the samples from patients with nonalcoholic cirrhosis (2.1 +/- 2.0 fmoles per mg of cytosolic protein). The cytosolic estrogen receptor content in the livers of patients with alcoholic cirrhosis who were abstaining was 4.2 +/- 3.6 fmoles per mg of cytosolic protein, but it increased to 10.4 +/- 4.9 fmoles per mg of protein in the livers of patients with alcoholic cirrhosis who were drinking, to 17.3 +/- 8.7 fmoles per mg of protein in the livers of patients with alcoholic hepatitis with cirrhosis and to 22.7 +/- 15.7 fmoles per mg of protein in the livers of patients with alcoholic hepatitis without cirrhosis. Alcohol abuse appeared, therefore, to induce an increase in the estrogen receptor content of human liver, especially in patients who were drinking and had histological evidence of acute liver damage (alcoholic hepatitis). The increase in hepatic estrogen receptor which we have observed may be involved in the molecular mechanisms underlying the feminization of the liver in alcoholic males.
Aged↗
Effects of hyperinsulinemia on vascular blood flows in experimental obesity.
Human obesity, which is very common in Polycystic Ovaries Syndrome and in "X Syndrome", constitutes an insulin-resistance state in which multiple clinical, biochemical and hemodynamic alterations coexist. Insulin resistance in the obese has been recently associated with an endothelial dysfunction. To investigate the possibility that clinical and metabolic derangements related to insulin resistance could induce changes in vascular blood flows, we have studied the levels of mesenteric (MBF), renal (RBF) and femoral (FBF) blood flows in Beagle dogs kept for 2 years on a normal (control group) or high fat diet (obese group). This experimental model exhibits many of the abnormalities with the human syndrome. In addition, we have tested the effects of chronic treatment with captopril (capto group) in monotherapy or in association with pravastatin (prava+capto group) on the hemodynamic changes associated with this diet. After the two year follow-up, Transonic flow probes were placed around the three arteries to measure basal blood flows and their response to a hyperinsulinemic-normoglycemic test in anesthetized animals. During this test the degree of insulin sensitivity was estimated. In association with higher body weight, blood pressure, insulin resistance, and fasting levels of insulin and total cholesterol, the obese group exhibited decreased basal levels of FBF and a greater femoral vasoconstriction during hyperinsulinism (P < 0.05 vs control). Combined therapy with captopril and pravastatin ameliorated the reduction in basal FBF and hyperinsulinism-induced vasoconstriction (P < 0.05), in addition to the beneficial effects on insulin sensitivity, and clinical and metabolic parameters. Synergistic beneficial effects of both drugs on lipid and carbohydrate profiles may account for this positive outcome, by attenuating the atherogenic process associated with this model.
Animals↗
Role of dose intensity in conservative treatment of anal canal carcinoma. Report of 35 cases.
Chemoradiotherapy (CRT) is considered the standard treatment for anal canal cancer. However, the optimum schedule of therapy has yet to be defined. This study was carried out to evaluate the role of dose intensity (DI) of chemotherapy (ChT) and radiotherapy (RT) on the outcome of patients submitted to CRT. Thirty-five consecutive patients with anal canal carcinoma received a combination of RT (median dose 56 Gy) and ChT (two or more cycles of 5-fluorouracil and mitomycin C). With a median follow-up of 33 months, 83% of patients are alive without evidence of disease and 70% are colostomy-free. Five-year actuarial disease-free survival (DFS) is 74%. Univariate and multivariate analysis was performed to determine the correlation of DFS with various clinical and therapeutic parameters. Our series confirmed the prognostic negative value of a tumor size >4 cm. An average relative dose-intensity (ARDI) >0.8 was related to a better outcome both in univariate and in multivariate analysis; an overall treatment time >70 days was related to a worse DFS in univariate analysis, but these data were not confirmed by the Cox model. RT dose was not associated with DFS. In conclusion, the results of this study seem to suggest an independent prognostic role of ChT DI, as measured by ARDI. The results regarding RT DI are inconclusive, and remain a matter for further trials.
Adult↗