Biomedical subjects

G De Angelis

Publications and source records attributed to G De Angelis.

At least 55 records · Page 3Linked to original sources

PubMed1997

Validation of an algorithm able to differentiate small-cell lung cancer (SCLC) from non-small-cell lung cancer (NSCLC) patients by means of a tumour marker panel: analysis of the errors.

By means of a mathematical score previously generated by discriminant analysis on 90 lung cancer patients, a new and larger group of 261 subjects [209 with non-small-cell lung cancer (NSCLC) and 52 with small-cell lung cancer (SCLC)] was analysed to confirm the ability of the method to distinguish between these two types of cancers. The score, which included the serum neuron-specific enolase (NSE) and CYFRA-21.1 levels, permitted correct classification of 93% of the patients. When the misclassifications were analysed in detail, the most frequent errors were associated with limited disease SCLC with low NSE levels and with advanced NSCLC with high NSE levels. This demonstrates the importance of the marker in correctly categorizing patients.

Adult↗

PubMed1996

Functional analysis of the preproendothelin-1 gene promoter in pulmonary epithelial cells and monocytes.

At least two human preproendothelin-1 mRNAs are produced by a single gene through the use of different promoters, and the mechanisms controlling the production of these alternative transcripts might be cell-specific. In human lung, endothelin-1 is produced by vascular endothelial cells, bronchial epithelial cells, and pulmonary monocytes/macrophages. Given the important role of endothelin-1 in the pathogenesis of some pulmonary diseases, we carried out a functional analysis of the preproendothelin-1 gene promoter(s) in bronchial epithelial cells and lung monocytes. Two distinct preproendothelin-1 mRNAs were expressed in the two cell populations. Using deletion mutants and enhancer trap transfection experiments, we also identified different regions of the preproendothelin-1 gene necessary for endothelin-1 expression in bronchial epithelial cells and pulmonary monocytes.

Base Sequence↗

PubMed1996

Carcinoembryonic antigen, tissue polypeptide antigen and neuron-specific enolase pleural levels used to classify small-cell and non-small-cell lung cancer patients by discriminant analysis.

The classification of lung cancer into small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC) is essential for disease prognosis and treatment. For this purpose, we have tried to optimize the use of three tumour markers determined on pleural effusions, to differentiate SCLC from NSCLC by means of a canonic variable, generated by discriminant analysis, including subjects with histologically proven lung cancer. Discriminant analysis was performed by using carcinoembryonic antigen, neuron-specific enolase and tissue polypeptide antigen pleural levels, determined in 65 consecutive and unselected patients, histologically classified as 49 NSCLC and 16 SCLC. To validate the formula generated, a control group of 37 lung cancer patients (10 SCLC and 27 NSCLC), enrolled subsequently, was employed. Applying the discriminant analysis to SCLC and NSCLC patients a good classification was obtained (92% rate of correct classification). The aforementioned formula, applied to the validation group, showed a 92% rate of correct classification. This method, which is rapid, inexpensive and routinely applicable to malignant pleural effusions, may be reliably used to classify lung cancer patients.

Adult↗

PubMed1996

Influence of blunt needles on surgical glove perforation and safety for the surgeon.

BACKGROUND: Round-tipped blunt needle (BN) may decrease the risk of needlestick injuries and hand contamination. We prospectively determined the incidence of glove perforations in emergency abdominal procedures and the efficacy of BN in increasing the safety for surgeons. METHODS: Two hundred patients were randomized to undergo closure of the abdominal fascia using sharp needle (SN) or BN. Gloves were tested at the end of the procedure. RESULTS: Surgeons had 14 needlestick injuries and 76 perforations recorded in 69 pair of gloves. Sharp needles were responsible for all injuries and 58 (76%) perforations (P < 0.00004 and P < 0.00001, respectively). This difference was still higher when considering the perforations related to the abdominal fascia closure (BN 7% versus SN 50%; P < 0.0006). CONCLUSION: The risk of glove perforation is sevenfold greater if SN are used. Blunt needles reduce sharp injuries and improve safety for surgeons.

Accidents, Occupational↗

PubMed1995

Discriminant analysis on small cell lung cancer and non-small cell lung cancer by means of NSE and CYFRA-21.1.

A correct diagnosis of small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) is essential both for prognostic and therapeutic reasons. We used discriminant analysis as a method to optimize the discriminant power of serum tumour marker levels for differentiation between SCLC and NSCLC. A panel of serum markers, including neurone specific enolase (NSE), cytokeratin fragment antigen 21.1 (CYFRA-21.1), tissue polypeptide antigen (TPA) and carcinoembryonic antigen (CEA) was obtained in 50 consecutive NSCLC and 17 SCLC. Data were analysed by the BMDP statistical program after logarithmic transformation of marker levels. The variables selected were NSE and CYFRA-21.1. Considered together, they were able to give a 97% rate of correct classification. The formula generated (canonic variable, CV) was validated on a group of seven SCLC and 22 NSCLC patients. Only two errors occurred. We therefore conclude that the canonic variable tested, based on NSE and CYFRA-21.1, provides a good discrimination between the two types of lung cancer. The method is rapid, relatively inexpensive, and based on simple serum tests.

Aged↗

PubMed1995

Evaluation of the response to chemotherapy in patients affected with small cell lung cancer using discriminant analysis: a preliminary report.

This report represents an attempt to combine the serum levels of more tumor markers together to evaluate the response to chemotherapy in 26 patients affected with small cell lung cancer (SCLC), by means of discriminant analysis. A pilot prospective study was performed on 26 subjects affected with inoperable SCLC (18 extensive diseases, and 8 limited diseases) and treated with chemotherapy (etoposide plus cisplatin regimen). Serum levels of a panel of tumor markers: Carcinoembryonic antigen (CEA), Tissue Polypeptide Antigen (TPA), Neuron Specific Enolase (NSE) and CYFRA -21.1 were determined before starting chemotherapy and at the restaging time (after 3 months). To optimize the classification power of these markers, a discriminant analysis was done, which permitted generating two classification functions, based on Tissue Polypeptide Antigen and Neuron Specific Enolase levels able to correctly classify 25 out of 26 subjects (8 progressions and 18 non progressions). The results obtained, furtherly confirm that tumor markers are useful to evaluate the chemotherapy response and indicate a possible approach to obtain the maximum usefulness of the serum marker levels.

Adult↗

PubMed1994

MIAMOD: a computer package to estimate chronic disease morbidity using mortality and survival data.

The MIAMOD package is for use in epidemiological analysis of chronic degenerative diseases. The package has been designed to use survival and mortality data supplied by the user, to estimate incidence and prevalence rates, to forecast future mortality and morbidity levels and to provide life tables. Estimates are derived by modelling incidence as an age-period-cohort function and by the equations relating specific cause mortality and prevalence to incidence and survival. The model parameters are evaluated by fitting mortality data by means of a weighted non-linear regression model. Numerical and statistical methods used to solve the regression and to compute standard errors, projections, and life tables are discussed. The program is written in standard FORTRAN 77 and runs on a mainframe computer. The different program units are illustrated together with the principal implementation options. An example of application is provided to show a typical output pattern.

Breast Neoplasms↗

PubMed1994

Mechanical performance of dental amalgam--composite interfaces.

Composite veneering of amalgam is the most aesthetical solution to extensive direct tooth restoration and is applied with success in specific clinical situations. An in-vitro technique has been used to evaluate the mechanical performance of one amalgam bonded to four different composites. The amalgam-composite interfaces were subjected to tensile stress and shear stress at break tests, using dumb-bell and sandwich specimens in a PC-controlled electronic dynamometer equipped with innovative grips. Mean values were higher for tensile stress than for shear stress. Further studies and clinical experimentation will be necessary to explore the question of long-term reliability.

Acrylic Resins↗

PubMed1994

[The minimally invasive treatment of bullous pneumopathy. The anatomicopathological and pneumological findings in 18 months of experience].

The authors present 18-month experience in the minimally invasive treatment of bullous pneumopathy and review of the relative literature. Results of pneumologic and pathologic studies are correlated with the advantages of the technique. Tobacco smoking, positive family history, associated disease and long standing treatments have been considered. Special attention is drawn to macro and microscopic findings. The authors concluded that: (a) There is a positive correlation between surgical technique of pleural cavity exploration and recidival pneumopathy. (b) There is no correlation between family history and pneumological and pathological findings. (c) A wider experience on bullous pneumopathy may offer new interesting pneumological knowledge.

Adolescent↗

PubMed1994

Who should prescribe long-term oxygen in patients affected by chronic arterial hypoxaemia?

Thirty two patients, 22 males and 10 females, mean age 69 yrs, affected by chronic arterial hypoxaemia due to chronic obstructive pulmonary disease (COPD), were included in a long-term oxygen therapy (LTOT) study. The aim of the study was to retrospectively evaluate the relationship between good education of the patients on long-term oxygen therapy and the different sources of prescription, i.e. general practitioners (GPs), the Departments of Internal Medicine, or our Department of Respiratory Medicine. The results showed that oxygen prescription and instruction in its use were correct more frequently when the recommendations were performed by the Department of Respiratory Medicine, and less frequently when the prescribers were general practitioners or Departments of Internal Medicine. Furthermore, the compliance of the patients to LTOT was significantly related to a specialized prescription, suggesting that oxygen therapy has to be the responsibility of the specialized units.

Aged↗

PubMed1993

[Correlation between C219 and drug resistance in lung neoplasms].

The authors take into consideration 19 cases of lung neoplasm to see the relationship of clinical behaviour and C219. They found a cutoff (25%) to separate drug resistant by drug sensibility. Marker sensitivity was 84.2% and relation with PCNA was negative (-0.384).

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed1993

VAD Biomer blood sacs: mechanical tests and ultrastructural observations.

Ventricular Assist Devices (VADs) are a support to the heart function and are used as bridge to transplantation for a brief period in patients awaiting a donor heart. They consist of two sacs with two artificial valves that allow blood flow, the whole connected to a specific electronic equipment. This study examines the performance of a segmented-polyurethane elastomer, namely Biomer, that has been extensively used to manufacture pneumatically actuated VAD blood sacs. Specimens obtained from three VAD blood sacs explanted from three human patients and specimens from one unimplanted blood sac were investigated for mechanical performance of the material and for the changes it undergoes as a result of mechanical stress and interaction with the surrounding biological environment. The application of tensile strength at break yielded no relevant differences between unimplanted and explanted specimens. Biomer exhibited a high elongation at break for both groups, with somewhat lower values for explanted specimens. SEM observations carried out on the inner surface--in contact with blood--of unstressed explanted specimens showed no thrombotic deposits, calcifications, microbial contamination or structural changes. The complementary broken surfaces of stressed specimens showed a distinctive fracture pattern.

Biocompatible Materials↗

PubMed1993

[Middle lobe syndrome].

The authors, based on their actual experience with four cases and using previously published articles, state the pathological and clinical features of the middle lobe syndrome. Considering the physio-pathological processes, the authors determine the therapeutic program: the first approach would be pharmacological, second, if necessary, surgical-seeking to be as conservative as possible.

Adolescent↗

PubMed1992

[Drainage of the pleural cavity].

The authors, from their personal experience, demonstrate the goals, the indications, the techniques and complications of performing a drain of the pleural cavity (DCP). DCP has an important role as a single operation or at the end of every thoracic operation. For this reason it is mandatory to respect the principles and the concepts reported by the authors.

Contraindications↗

PubMed1992

Estimated incidence and prevalence of female breast cancer in Italian regions.

Female breast cancer incidence and prevalence in Italy have been estimated by region and vast areas from population-based survival data of breast cancer patients and 1970-1987 specific mortality data using a mathematical model. Italian age-standardized incidence rates (ASR) for 1987 range from 70 to 90 per 100,000 women-year in the Northern regions, 55 to 73 in the Center, and 45 to 72 in the South. Overall, the ASR is about 80 in the North, 70 in the Center and 60 in the South. In the absence of competitive mortality, breast cancer cumulative risk in the 0-74 years life span is about 7 women out of 100 in the North, 6 in the Center and 5 in the South. The decreasing risk pattern from North to Center then South appears less evident when under 45 age-specific rates are considered. Very high levels for young age-groups are present both in the North (Liguria and Emilia Romagna) and South (Sardinia and Apulia). The incidence pattern by age differs from region to region and over the considered period, suggesting that a birth-cohort effect is crossing the whole country. Using to model, it can be estimated that the risk by cohort increases from the generations born at the beginning of the century to those born in the 40s, after which, for subsequent generations, it has been decreasing in all the considered areas and is similar in the North and South. We can infer that for the whole country the incidence will increase up to the years 2000-2010 when those birth-cohorts at higher risk will also be at higher risk for age. In 1987, about 250,000 Italian women had a present or past history of breast cancer: for the 1970-1987 period, prevalence has increased by approximately 5,500 cases per year.

Age Factors↗

PubMed1992

[Incidence and prevalence of respiratory tumors in Italy. Estimation from mortality data].

This study estimates the incidence and prevalence of larynx and lung cancers using a mathematical model based on available data on specific mortality and survival. In Italy, larynx and lung cancers account for more than 95% of respiratory cancers. In this paper, estimates of age/sex-specific and age-standardized incidence rates and prevalence are presented for the years 1970 and 1987. Age and birth-cohort effects on incidence are also presented by sex and broad geographical area. The procedure was firstly validated using data from four cancer registries: Varese (Northern Italy), Parma (North-Central Italy), Florence (Central Italy), and Ragusa (Southern Italy). Estimates were then carried out at the national level and for each major geographical area (i.e. North, Center and South). Larynx cancer age-standardized incidence rates increased for men by about 25% from 1970 to 1987. Age-specific rates increased for ages greater than 44 years, but decreased for younger ages. Cohort effects are low for older cohorts; they steeply increase and plateau for the 1900-1905 cohorts, and then peak for the 1930 cohort. The risk for cohorts born after 1930 systematically decreases. We estimated that the 1930 birth cohort has a risk five times higher than the 1890 cohort. For women, the incidence rates increased by about 30% from 1970 to 1987, for all age classes. Cohort effects steadily increase from the 1886 birth cohort to the 1960 cohort. The estimated prevalence between ages 30 and 84 increased from about 24,400 cases in 1970 (23,000 males and 1,400 females) to about 51,400 cases in 1987 (48,600 males and 2,800 females). For men, 42% of the increase can be attributed to an increase in the incidence of the disease; 45% can be attributed to population aging, and only 13% to an increase in the survival probability. Corresponding figures for women are 42%, 48%, and 10%. For lung cancer, we estimated 32,000 incident cases for 1987 (28,000 men and 4,000 women), two times the corresponding figures for 1970 (14,000 men and 2,000 women). Looking at age-adjusted rates, the overall risk of lung cancer increased by about 60% for men and 52% for women during a period of 17 years. Age-specific incidence rates increased proportionally with age for ages greater than 50 years. By contrast, there was a slight but systematic risk reduction in younger age classes.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed1991

[Risk factors in the surgical patient over 80].

Authors present the experience about 266 elderly patients treated by surgery since 1985 to 1990. The range of the patient's age is comprised between 74 and 89. 113 patients (42%) have been treated in emergency, with 12% mortality. Authors report the different experiences in relation to various kinds of operations: thorax, vascular, digestive surgery, and to their level of trauma to the patients; "major surgery" distinguished from "little surgery". Elderly age is not considered as an inhibiting limit to major surgery. Only the emergency treatment leads to different situations with more risks. Absolutely necessary in the knowledge of the physiopathological modification of the elderly, and his nutritional and performance status.

Age Factors↗

PubMed1991

[Recurrent hepatic echinococcosis. A case report and review of the literature].

The paper report a case of postoperative recurrent hydatid disease in a fifty-year-old man. The scarcity of published works on the etiological causes of this pathology and the lack of an uniform treatment protocol necessitate a correct and radical surgical approach. The patient underwent cystopericystectomy and after three months follow-up is still free of disease.

Echinococcosis, Hepatic↗