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Biomedical subjects

F Colombo

Publications and source records attributed to F Colombo.

At least 181 records · Page 10Linked to original sources

Care of cancer patients in thirty-one Italian general hospitals. Methodological aspects and general findings.

A large sample of cancer patients was reviewed over a two-year period (1978-1979) in 31 general and community hospitals representing five Italian regions, differing in terms of health care organization. Two thousand four hundred and six patients had breast cancer, 1692 lung cancer, 303 non-Hodgkin's lymphomas, 277 ovarian cancer and 235 Hodgkin's lymphoma. Relevant information was collected from medical records through specific pre-standardized and tested forms. The paper discusses the results obtained with respect to (a) general descriptive data of the population; (b) completeness and reliability of recorded data (e.g. staging, histological classification, therapy); and (c) accuracy and completeness of the follow-up. Consistency of the information obtained on selected items with published series of patients suggests that this methodology is worth a wider testing as a simple, inexpensive tool for routinely monitoring the care of cancer patients and the impact on it of organizational and educational interventions.

Adolescent↗

Ten-year survival in 290 patients with endometrial cancer: prognostic factors and therapeutic approach.

Between 1970 and 1976, 290 patients with endometrial cancer were treated at the 1st Obstetrics and Gynecology Clinic of the University of Milan. The median age was 62 years. Surgery was completed in 262 (90.3%) patients. Abdominal hysterectomy was used in 158 (70.9%) stage I and 40 (71.4%) stage II/III) patients; vaginal hysterectomy in 55 (24.7%) stage I and nine (16.1%) stage II/III patients. Resection of the upper vagina was performed in 168 patients. Postoperative external beam radiotherapy was used in stage II/III patients and in 44 (19.7%) stage I high-risk patients. Ten-year survival, determined by the life-table method, was 84.8% in stage I (223 patients), 53.4% in stage II (37 patients), 64.4% in stage III (19 patients), and 9.1% in stage IV (11 patients). Factors associated with poorer prognosis were: late age at diagnosis (P less than 0.001); deep myometrial invasion (P less than 0.001); poorly differentiated histological grade (P = 0.11); lack of resection of the upper vagina (P = 0.13). The role and importance of surgery is discussed, with special emphasis on the selective use of the vaginal route in aged, obese and medically high-risk patients.

Adult↗

Human exposure to heavy metals. Rare earth pneumoconiosis in occupational workers.

A male subject exposed for many years to rare earth (RE)-containing fumes and dusts emitted from carbon arc lamps in photoengraving laboratories was investigated to rule out RE pneumoconiosis. While chest x-ray films showed a severe pulmonary fibrosis, clinical analysis showed obvious high RE concentrations in the pulmonary and lymph node biopsy specimens compared with the corresponding tissues of 11 unexposed subjects. In addition to other elements, levels of thorium (Th), which is generally present as an impurity of RE compounds, were also determined to estimate the radiation dose which may be involved in inducing pneumoconiosis. The results show that the levels of Th are more than two orders of magnitude lower than the maximum permissible concentration for occupational exposure to natural 232Th, suggesting that the long-term accumulation of RE in the lungs played a role in the pathogenesis of the observed pulmonary fibrosis of the worker.

Biopsy↗

Cognitive outcome and early indices of severity of head injury.

Neuropsychological outcome of 100 patients with severe head injuries is correlated with their clinical condition on admission. The aim of this paper is to estimate the reliability of several early indices of brain damage severity in formulating a prognosis. Both the Glasgow Coma Scale and the neurological syndrome involved appeared to be highly reliable in this respect. The duration of coma and of posttraumatic amnesia was not as significant. Since these two parameters were assessed when reviewing the cases, they have to be considered only as retrospective judgments. The findings emphasized the importance of reflex ocular motility and the value of recording electroencephalographic (EEG) activity, particularly EEG sleep patterns. The relationship between rapid eye movement sleep impairment and cognitive defects was highly significant. Analysis of surgical observations demonstrated that purely compressive expanding lesions were not as harmful as parenchymal damage. Of paramount importance was the time lapse between injury and surgery, since secondary lesions may develop and affect cerebral areas that are involved both in sleep organization and in memory functions.

Brain Injuries↗

Quality of breast-cancer care in Italian general hospitals.

The diagnostic and therapeutic care and degree of follow-up delivered to 2406 breast-cancer patients over two years (1978-79) in 31 Italian hospitals are reviewed. Although there was broad agreement about recommended treatment protocols, staging by standard methods was recorded in only 44% of patients, assessment and reporting of side-effects was considered in only 49% of all treated patients, follow-up data at two years were available for only 54% of living patients, and the dropout rate from chemotherapy protocols was 35%. Improvement of these unsatisfactory aspects of care would allow a better appreciation of the real benefit that could be achieved with recommended protocols and would result in a more effective use of health resources.

Female↗

Long-term occupational risk of rare-earth pneumoconiosis. A case report as investigated by neutron activation analysis.

A case of rare-earth (RE) pneumoconiosis is described and discussed. A man working in a lithographic laboratory as a photoengraver, and exposed to the smoke of cored carbon arc lamps over a period of 46 years developed an interstitial pneumoconiosis. Neutron activation analysis (NAA) of eight rare-earths (La, Ce, Nd, Sm, Eu, Tb, Yb and Lu) in lung and lymph node biopsies showed an abnormally high amount of these elements in comparison to the corresponding values of 11 autopsied for unexposed subjects. The estimated radiological dose due to the inhalation of natural thorium, as calculated from NAA of thorium in the biopsies, tends to exclude the effect of ionizing radiation in the pathogenesis of lung fibrosis. Effects of other potential pathogenetic agents such as coal or heavy metal dusts, other than RE, irritative agents such as nitrous and hydrofluoric vapours originated during the photoengraving process, are also discussed. The findings strongly suggest that a relationship exists between the pneumoconiosis diagnosed and the occupational exposure to rare-earth dusts calling attention to proposals for maximum permissible concentration limits of occupational exposure to RE in air.

Animals↗

Platelet function in rheumatoid arthritis.

Platelet function tests were evaluated in 20 patients with rheumatoid arthritis (RA), 9 of whom displayed thrombocytosis (greater than 400,000 platelets/microliter). Most patients had an enhanced sensitivity to collagen and epinephrine induced aggregation, as compared with a reference group. In contrast, malondialdehyde (MDA) production, an index of platelet arachidonic acid metabolism, was in the normal range for all the patients except 3, who were LE phenomenon positive. The hypersensitivity of platelets to aggregating stimuli was particularly marked in thrombocytotic patients, who also showed the most striking biochemical and clinical abnormality. These findings indicate the crucial role of platelets in the development and self-sustaining of RA.

Adult↗

[Truncal vagotomy and cholelithiasis].

A group of 50 patients with total vagotomy plus pylorolasty are studied with pre and postoperative cholecystography in a four years follow-up. 50 patients with parietal cell vagotomy (selective vagotomy) served as control group. The AA. study the correlation of gallbladder dilatation with gallstones formation after total vagotomy. On the contrary parietal cell vagotomy prevents these dysfunctions.

Cholelithiasis↗

A new method for utilizing CT data in stereotactic surgery: measurement and transformation technique.

The proposed system is essentially based on the definition of a coordinate system, rigidly connected with the skull, by the introduction of three reference X-ray opaque points, secured into the bone of the skull. Target and reference points CT coordinates are given by the image display console. The three reference points are also identified on stereoradiographs, and their actual stereotactic coordinates are calculated by a geometrical approach which takes into account radiological distortion. A programmed computer links the target, identified on tomograms, to the three points system and calculates its stereotactic coordinates.

Humans↗