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Biomedical subjects

G Cortese

Publications and source records attributed to G Cortese.

At least 19 recordsLinked to original sources
PubMed2005

Three-year findings of an early lung cancer detection feasibility study with low-dose spiral computed tomography in heavy smokers.

BACKGROUND: Low-dose spiral computed tomography (sCT) showed a four-fold increase in the detection rate in high-risk subjects and a higher percentage of stage I lung cancer in comparison with chest X-ray. However, there is a considerable discrepancy among studies in the percentage of lung nodules, overall lung cancer and stage I detection rate. SUBJECTS AND METHODS: From April to December 2001, 520 asymptomatic volunteers aged >or=55 years with a history of cigarette smoking >or=20 pack-years and no previous cancer were enrolled to receive an annual sCT of the chest for five consecutive years. RESULTS: Seventy three per cent were male, median age was 59 years and 91% were current smokers. At baseline, nodules >or=5 mm were detected in 114 (22%) undergoing sCT; the size of lung nodules ranged from 5 to 9.9 mm in 81.5% of the cases. Five (1%) cases of lung cancer were detected. In two additional cases a pathological diagnosis of atypical adenomatous hyperplasia was made. Three new cases of lung cancer were detected in the second and third year of the study. One interval case was detected during the third year. CONCLUSIONS: Despite some promising data, convincing evidence from ongoing randomized trials is needed to support the routine use of sCT as a recommended tool for screening of lung cancer.

Aged↗
PubMed2003

Treatment of blepharospasm with botulinum neurotoxin type A: long-term results.

PURPOSE: To describe the long-term efficacy and side effects of treatment of blepharospasm with botulinum neurotoxin type A (Botox). METHODS: A total of 178 patients with blepharospasm were treated by injections of botulinum toxin in the Eye Clinic of the University of Naples from 1980 to 2001. The severity of spasm for each patient was graded on a four-point scale. Duration of improvement was assessed and reported in months. RESULTS: Of 178 cases, 10 were lost to follow-up; of the remaining patients, 93% reported improvement after treatments. The mean duration of improvement was 3.6 months. Twelve patients (76%) who underwent more than 14 treatments maintained stable relief. Three patients (1.7%) had a total remission of spasms. Side-effects were local; none of the 168 patients experienced any systemic or toxic reaction. CONCLUSIONS: Botulinum toxin therapy for blepharospasm can provide long-lasting relief and reduction of spasms in the majority of patients. This therapy has the advantages of being safe, simple, and repeatable.

Adult↗
PubMed2001

[Usefulness of chest X-ray during cystic fibrosis exacerbation in adult patients].

PURPOSE: Verify the real usefulness of chest X-ray during clinical exacerbation of cystic fibrosis (FC). MATERIAL AND METHODS: The study was based on a group of 46 adult patients affected by FC. For every subject we selected one or more pair of chest films, of which the first was used as reference image (To), whereas the second (T1) was selected among the following controls, either in course of clinical obvious exacerbation, or during another routine control. The 64 pairs of chest films (32 representing phases of clinical stability, 32 documenting evolution towards clinical deterioration) were subjected to evaluation by two radiologists, who were first asked to judge if stability, improvement or worsening of the overall radiographic picture could be observed; then to estimate the improvement, worsening, stability or absence of the 12 radiographic signs, selected among those more frequently correlating with the acute phase of disease. RESULTS: The comprehensive radiological evaluation, which shows a statistically significant difference (p=0.012) between the two groups considered, weakly correlates with the patient clinical status. Among the patients with exacerbation, the radiographic picture appeared worsened in only 18/32 cases (sensibility 56%, specificity 78%), while on the contrary 7/32 clinically stable patients exhibited a radiographic deterioration. Among the considered radiographic-sings, some were exclusively observed during exacerbation (specificity 100%), but with low sensitivity (pneumothorax: 6%, increment of bronchiectasis: 9%, air space disease 22%); the most common alterations (mucoid impactions and bronchial wall thickening) were observed in both groups of patients. DISCUSSION AND CONCLUSIONS: Our results demonstrate that there is not a precise correlation between the radiographic picture and the clinical manifestations of exacerbation and confirm the poor usefulness of chest X-ray in such a phase of disease. Chest X-ray is needed to exclude pnemothorax or extensive air space disease, rather then to accurately diagnose exacerbation.

Acute Disease↗
PubMed2000

Exhaled nitric oxide in systemic sclerosis: relationships with lung involvement and pulmonary hypertension.

OBJECTIVE: To measure nitric oxide (NO) concentration in exhaled air of patients with systemic sclerosis (SSc) and to investigate its relationships with lung involvement, complicated or not by pulmonary hypertension (PH). METHODS: Exhaled NO was measured by chemiluminescence in 47 patients with SSc (16 with PH) and in 30 controls. All the patients underwent Doppler echocardiography to assess pulmonary artery pressure (PAP), lung function tests, and thin section computed tomographic scans of the lung to quantify the extent of fibrosing alveolitis. RESULTS: Exhaled NO levels were higher in patients with SSc (16.6 +/- 9.1 ppb), particularly those with interstitial lung disease (ILD) (18.3 +/- 10.4 ppb), compared to controls (9.9 +/- 2.9 ppb; p < 0.0001). In patients with PH, exhaled NO was less than in patients without PH (10.7 +/- 5.9 vs 19.6 +/- 9 ppb, respectively; p < 0.001), and patients with PH without ILD had even lower exhaled NO than patients with PH and ILD (6.6 +/- 1.1 vs 12.6 +/- 6.3 ppb; p = 0.004). There was an inverse correlation between PAP and exhaled NO (r = 04).53, p = 0.004). Exhaled NO was not correlated to age, disease duration, current therapy, or form of disease (limited or diffuse). CONCLUSION: The increased concentration of exhaled NO in patients with SSc may reflect respiratory tract inflammation. The relatively low value of exhaled NO in patients with PH and the negative correlation between PAP and exhaled NO suggest the important role of NO in regulating pulmonary vascular resistance in patients with SSc.

Adult↗
PubMed2000

[Characterization of non-secreting adrenal nodules (incidentalomas): role of multiphasic spiral computerized tomography].

PURPOSE: To evaluate the diagnostic yield of multiphasic helical CT in the characterization of single non functioning adrenal nodules (incidentalomas) less than 50 mm in diameter. Emphasis was given to the possible replacement of unenhanced with delayed scans in cancer patients undergoing staging procedures. MATERIAL AND METHODS: Sixty patients with single adrenal nodules (30 of them neoplastic and 30 non-neoplastic) were examined with thin unenhanced scans (5 mm), early scans after administration of a contrast agent (120 mL at 2.5 mL/s with 60 s delay) and late scans (30 min delay). RESULTS: On both unenhanced and late scans a threshold could be selected on the Hounsfield unit scale which guaranteed absolute specificity in the characterization of adenomas (100% specificity) with very high sensitivity (93% at both scans): this threshold was 19 HU on unenhanced and of 41 HU on late scans. In contrast, at early delayed scanning the threshold which guaranteed 100% specificity was associated with negligible sensitivity (30%). The evaluation of lesion size had no diagnostic value, since the mean diameter of both benign and malignant nodules was of 25 mm. CONCLUSIONS: Late scans have diagnostic yield comparable to unenhanced scans: at the selected delay (30 min), benign lesions nearly always have lower attenuation values than malignant nodules and can be diagnosed with confidence when they exhibit mean attenuation values lower than 41.

Adenoma↗
PubMed1996

Induction of humoral immunity toward 2-acetylaminofluorene in mice: modulation of DNA binding after 4 weeks dietary exposure to the carcinogen.

In order to investigate the modulatory effect of the immune response induced by recurrent carcinogen exposure, anti-2-acetylaminofluorene (anti-2-AAF) IgG were elicited in Swiss mice before subsequent carcinogen administration. The immunization schedule consisted of three weekly i.p. injections of 2-acetylaminofluorene (2-AAF)-gelatin conjugate, followed by a final immunogen injection 14 days later. At the end of treatment, the presence of specific anti-2-AAF antibodies in blood serum of all immunized animals was demonstrated. The immunization procedure did not affect liver metabolic activities, as evaluated using liver homogenates for the exogenous activation of 2-AAF to mutagen. After immunization, mice were fed 2-AAF pelleted in the diet at 50 and 150 p.p.m. for 4 weeks and killed at the end of treatment. The determination of DNA adducts by ELISA in liver and spleen of treated animals revealed significantly (P < 0.01-0.001) lower 2-AAF adduct levels in both tissues of immunized mice with respect to non-immunized animals (both naive and pretreated with the adjuvant alone). This result suggests that the specific humoral immunity elicited by repeated carcinogen exposure may be able to modulate the genotoxic effect induced by subsequent carcinogen administration.

2-Acetylaminofluorene↗
PubMed1996

Modulation of DNA binding in vivo by specific humoral immunological response: a novel host factor in environmental carcinogenesis?

To investigate the possible modulatory effect of the immune response induced by recurrent carcinogen exposure, a specific humoral immune response toward 2-acetylaminofluorene (2-AAF) was elicited in Swiss mice with repeated intraperitoneal injections of a 2-AAF-gelatin conjugate. The immunization procedure resulted in the production of specific anti-2-AAF antibodies in all treated animals. Groups of immunized and nonimmunized mice were subsequently fed 2-AAF pelleted in the diet at 50 and 150 ppm for 4 weeks. At the end of 2-AAF administration, animals were sacrificed and the content of 2-AAF-adducts in liver DNA was determined by enzyme-linked immunoadsorbent assay using a polyclonal rabbit antiserum. The comparison of the adducts levels in immunized and nonimmunized mice (receiving either the vehicle or the adjuvant alone during pretreatment) demonstrates a highly significant (p < 0.001) difference among groups, with far lower adduct levels in immunized animals. No significant difference in food consumption or liver metabolic activities was observed among experimental groups, suggesting the absence of external bias. The mechanism underlying the result observed is not yet clear; however, the experimental data strongly suggest that the specific immunological response induced by recurrent carcinogen exposure may exert a modulatory effect and act as a relevant host factor in chemical carcinogenesis.

2-Acetylaminofluorene↗
PubMed1993

[Computerized tomography of cerebrovascular disorders in old age].

The authors present and demonstrate the more typical CT patterns of cerebrovascular diseases in old age, on the basis of literature and of personal experience of more than 1000 CT examinations of old patients in 1991-1992. They stress the basic role of CT in differential diagnosis between hemorrhagic and ischemic lesions. Finally, they propose a protocol for the better use of CT in the early diagnosis and the outcome of cerebrovascular diseases.

Aged↗
PubMed1989

[Accuracy of CT in the demonstration of lymph node metastasis in pulmonary carcinoma].

The CT, surgical and histological findings were examined of 350 lymph nodes in a perspective study of 50 patients affected with lung cancer. CT accuracy could thus be evaluated in assessing the size of hilar and mediastinal lymph nodes; the incidence of histologically-proven metastases in nodes more/less than 10 cm in diameter could also be determined, together with CT diagnostic accuracy for nodal metastases. Finally, CT capabilities were also evaluated in distinguishing N0 from N1-N2 patients. CT proved to have high negative predictive value and low positive predictive value, which caused the authors to raise the normal threshold value of CT evaluation of the greatest diameter for hilo-mediastinal nodes from 10 to 20 mm.

Humans↗
PubMedDate not supplied

[Nasosinus tumors: the problem of orbital invasion].

Neoplasms of the nasal cavity and paranasal sinuses constitute less than 1% of all malignant tumors and account for 3% of those within the E.N.T. field. The course of said pathologies is characterized by scant lymph node metastases and by a marked tendency toward local evolution. Since symptoms are not particularly specific diagnosis is normally arrived at late (approximately 6 months after the first symptoms) when the disease is already in an advanced stage. The orbital area and its contents are quite difficult to study both from a clinical point of view and in terms of testing methodology. Orbital symptoms exist at onset in from 25-30% of the cases. On the other hand, when evaluated upon surgery, orbital invasion is encountered in 40% of the patients. Unfortunately radiology is not always able to provide all the information a surgeon requires in order to establish the proper approach. Although CT is able to provide information regarding extension of the lesion to the soft parts it is not equally able to confidently diagnose initial infiltrations into the bony walls of the orbita. A sampling of 31 patients with tumors of the nasal cavity and paranasal sinuses was studied. All subjects underwent careful radiological examination and were treated with a combination of surgery and radiotherapy. Upon clinical examination orbital invasion was suspected for 50% of the cases. Only in 40% of the cases did radiology confirm this while in 60% it was confirmed by surgery. It is worth noting that during surgery only half of the cases of such invasion were deemed as requiring orbitectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗