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Biomedical subjects

F Andreoli

Publications and source records attributed to F Andreoli.

At least 19 recordsLinked to original sources

Management of true splenic artery aneurysms. Two case reports and review of the literature.

Few series of splenic artery aneurysms (SAA) have been reported, but today asymptomatic SAA are detected with increasing frequency. Their importance lies from their potentially fatal consequences as life-threatening hemorrhage. SAA management still remains controversial as reported in this review. Our 2 patients treated with resection of the aneurysms, both located in the middle third of the splenic artery. Some authors demonstrated that when splenic artery has been ligated (or embolized) and the patients remain anatomically splenic, they may not retain any splenic function. Laparoscopic SAA ligation repair appears to be optimal and useful for aneurysms protruding from the pancreas and it is gaining interest because clinical recovery is rapid with a poor morbidity and economic and cosmetic advantages. Transcatheter embolization too offers a temporary control in urgency to stop hemorrhage and go back at later date to make much better elective operation. Endovascular interventions as percutaneous embolization has recently gained popularity: it offers a safe alternative or adjunctive therapy to traditional surgery. We hope in the future instrumentation will likely improve so that this procedure can be done percutaneously by development of prosthetic devices in the 21th century.

Adult↗

Raltitrexed plus oxaliplatin as first-line chemotherapy in metastatic colorectal carcinoma: a multicentric phase II trial.

For advanced colorectal carcinoma, two new drugs, raltitrexed (TOM) and oxaliplatin (L-OHP), have recently shown interesting results. Preclinical and clinical studies suggest that this combination, because of its favorable toxicity profile, high response rate and convenient schedule of administration, can be administered successfully in this disease. In our phase II study, 37 non pre-treated patients with metastatic colorectal carcinoma were treated with TOM (3 mg/m(2)) and L-OHP (130 mg/m(2)) every 3 weeks. In total, 222 cycles were administered; all patients received at least 2 cycles (median 6, range 2-8). There were two complete and 14 partial responses for an overall response rate of 43% (95% CI 27-69%). The median time to response was 2.5 months (range 2-4) and the median duration was 10.3 months (range 5-18). Twelve of the 23 (52%) patients with symptomatic colorectal cancer were classified as clinical benefit responders for at least 4 weeks during the study period. Treatment was well tolerated, and both acute, essentially hematologic, and cumulative hepatic and neurologic toxicities were manageable and reversible. Response rate and toxic effects observed during this study warrant additional studies comparing this TOM-L-OHP regimen with CPT-11 and/or capacitebine-containing regimens in metastatic colorectal carcinoma.

Adult↗

Randomized trial of adjuvant chemotherapy versus control after curative resection for gastric cancer: 5-year follow-up.

Adjuvant chemotherapy of gastric cancer after curative resection is still subject to discussion. In this study 137 patients with gastric adenocarcinoma, all with positive nodes, were randomized after curative resection so that 69 received epidoxorubicin (EPI), leucovorin (LV) and 5-fluorouracil (5-FU) on days 1-3 every 3 weeks for 7 months, whereas the remaining 68 did not. After a follow-up period of 5 years, 21 of the 69 treated patients (30%) and nine controls (13%) were still alive; median survival time was 18 months for the controls and 31 months for the patients treated with adjuvant chemotherapy (P< 0.01).

Adenocarcinoma↗

Results of leucovorin and doxifluridine oral regimen in the treatment of metastatic colorectal cancer.

We conducted a multicentric phase II study on advanced colorectal cancer to determine the efficacy and toxicity of oral treatment with leucovorin (LV) plus doxifluridine (5'DFUR), a novel fluoropyrimidine derivative with proven antitumor activity in different experimental models. Thirty-six outpatients with measurable disease entered the trial and received orally LV 20 mg in the morning and in the afternoon, and 2 h later 5'-DFUR 500 mg/m2 every 2 days for 3 months. Thirty-four evaluable patients underwent a total of 408 weeks of treatment. The response rate was 35%, with two complete remissions and 10 partial responses. The median survival of patients who responded to treatment (responders) was 17.1 months (range 4-32), which was significantly longer (p<0.001) than the 6.5 months (range 2-11) of the patients who did not respond (non-responders). Therefore, after 4-8 weeks of treatment, 14 patients (41%) had an improvement in their performance status and/or stabilization of pain. General toxicity was usually mild, myelo and gastrointestinal toxicity were moderate, and there was no evidence of relevant neurological toxicity. These results show that a home therapy with oral LV-5'DFUR is a safe and effective treatment regimen for metastatic colorectal carcinoma.

Administration, Oral↗

Adjuvant chemotherapy after gastric resection in node-positive cancer patients: a multicentre randomised study.

After curative resection for gastric adenocarcinoma, 103 patients, all with positive nodes, were randomised so that 48 received adjuvant chemotherapy of epidoxorubicin (EPI) 75 mg m-2 on day 1, leucovorin (LV) 200 mg m-2 on days 1-3 and 5-fluorouracil (5-FU) 450 mg m-2 on days 1-3, every 21 days for 7 months, whereas the remaining 55 did not. During the first year of observation, 21 control patients (38%) and five treated patients had recurrences. After a follow-up period of 36 months, 12 of the treated patients (25%) and only seven controls (13%) were still alive. At that point, the median survival was 13.6 months for the 55 untreated patients and 20.4 months for the 48 treated patients, a significant difference. We found a survival advantage for patients treated with the EPI-LV-5-FU regimen and a consistent delay in the appearance of recurrent or metastatic cancer. Acute toxicity was mild and treatment was well accepted by all patients. There was no long-term toxicity or any cardiac toxicity. We conclude that this particular chemotherapy, administered shortly after gastric resection, improves survival rate in node-positive gastric cancer patients, even although final assessment of this particular adjuvant approach must await completion of the trial.

Adenocarcinoma↗

Epidoxorubicin and high dose leucovorin plus 5-fluorouracil in advanced gastric cancer: a phase II study.

We conducted a multicentric phase II study on advanced gastric cancer to determine the efficacy and toxicity of treatment with epidoxorubicin (EPI) plus high doses of leucovorin (LV) and 5-fluorouracil (5-FU). Thirty-seven patients with measurable disease were enrolled into the trial and treated with EPI 75 mg/m2 on day 1 and LV 200 mg/m2 plus 5-FU 450 mg/m2 from day 1 to 3, the cycle being repeated every 3-4 weeks from a median of five cycles per patients. The response rate was 49% in 35 evaluable patients, with two complete remissions and 15 partial responses. Median response duration was 12.4 months; median survival for responding patients was 17.3 months, which was significantly longer than 8.7 months for non-responding patients. General toxicity was usually mild, myelotoxicity was moderate and there was no evidence of cardiac toxicity. These results show that EPI-LV-5-FU is an effective regimen for advanced gastric carcinoma. The efficacy of this combination should now be tested as an adjuvant therapy in resectable gastric cancer.

Adult↗

[The Angelchik prosthesis. A computed tomography study].

The Angelchik prosthesis is used in the surgical treatment of gastroesophageal reflux. Operated patients are primarily examined with imaging techniques, but manometric and acidometric techniques are also used. Although the conventional esophagogram still maintains its diagnostic significance, computed tomography (CT) has become the first-choice imaging modality. CT allows the correct evaluation of both the state of the prosthesis and its relationship to the esophagus and the gastric fundus. The possible postoperative complications following an incorrect placement of the prosthesis can be accurately diagnosed too. The authors report their experience in the study of 5 patients examined with both conventional radiology and CT.

Contrast Media↗

[Early puerperal depression: the puerperal blues].

The incidence and morbidity factors as regards non-psychotic depression during the puerperium (puerperal blues or maternity blues or post-partum blues) has been investigated in 50 females at random. Puerperal blues was diagnosed as the presence of depression in keeping with Kellner's symptomatic questionnaire. Approximately two-thirds of women experience depression during the early puerperium. Primiparas, patients who have had traumatic delivery (cesarean delivery) and those who have had considerable traumatic experience during pregnancy, and/or presented a previous history of psychopathological disorders, are more subject to puerperal blues.

Depression↗

Intragastric pH continuously monitored in health and in gastric diseases: chronobiologic assessment.

Some gastric diseases clinically show ultradian, circadian, and circannual periodicities. We continuously monitored, during a single 24-hr span, with a fully electronic, solid-state portable recorder, endoluminal gastric pH in five healthy subjects, in some patients with gastric diseases including duodenal ulcer and gastric cancer, and in high-risk persons prone to develop duodenal ulcer and gastric cancer. The daily schedule and the timing of standardized meals for each subject were strictly verified. All stored data (300 time points/subject) were decoded, read, and analyzed by an inferential statistical method to estimate the rhythm parameters. The intragastric dense pH samples showed highly significant circadian and ultradian (8-hr) rhythms in all investigated subjects, but rhythm parameters differed in pre- and in overt pathology.

Duodenal Ulcer↗

Anorectal continence and bladder function. Effects of major sacral resection.

The effect of sacral resection up to S-2 has been investigated in two patients with "chordomas," surgical division of the spinal roots was unilateral and bilateral, respectively. Anal manometry, electromyography of the sphincters, and the ascertaining of tactile, thermic, and painful stimuli perception in the perineum and anal canal were executed to determine the effects of denervation on anorectal continence. Vesical function was tested by vesical manometry. Results differ strongly between the two patients: the first, with unilateral loss of S-2, has perfect anorectal continence. The second, with bilateral loss of S-2, is incontinent and unable to discriminate rectal contents. It is sufficient to retain only one S-2 root for the maintenance of physiologic continence, including distinction between different types of bowel contents (gaseous or solid) passing through the anal canal. The same is true concerning bladder function.

Anal Canal↗

Radioimmunoassay of gastrin in human saliva.

We have developed a personal procedure for the radioimmunoassay of gastrin (lower detection limit 3 pg/ml). Using 5-fold concentrated lyophilized salivary samples, we are able to detect the basal content of gastrin immunoreactivity in saliva of normal fasting people (mean +/- SD: 1.38 +/- 0.61 pg/ml) compared to plasma gastrin (mean +/- SD: 28.88 +/- 11.00 pg/ml). We found that after meal stimulus, the value of salivary as well as plasma gastrin concentration increased (the correlation coefficient r among salivary and plasma gastrin being 0.899; p less than 0.001). We believe that gastrin appears in a very low concentration in saliva and that it is not produced by the gland, but derives probably from the serum clearance.

Gastrins↗

[Gastroesophageal reflux of mixed type].

Gastroesophageal reflux has been showed both clinically and experimentally to be especially damaging esophageal mucosal layer when the elements which make up reflux are gastric content and bilio-pancreatic juice.

Duodenogastric Reflux↗

[Histopathology of reflux esophagitis at an early phase. Study and significance of intraepithelial eosinophilia].

The diagnosis of reflux esophagitis in the early stage is not easy because endoscopy rarely shows evident findings and histology of biopsy specimens still appears unclear and doubtful. Usual histopathological findings are reported and most available diagnostic criteria are discussed, on the basis of the literature and personal experience. Intraepithelial eosinophils are a possible marker of early reflux esophagitis: its diagnostic usefulness is outlined.

Biopsy↗