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Biomedical subjects

G Gasparini

Publications and source records attributed to G Gasparini.

At least 163 records · Page 9Linked to original sources
PubMed1989

Low-dose aminoglutethimide plus steroid replacement in advanced breast cancer patients resistant to conventional therapies.

In an attempt to define the activity and toxicity of low-dose aminoglutethimide plus steroid replacement in advanced breast cancer, we treated 40 patients with aminoglutethimide 500 mg/day + hydrocortisone 50 mg/day. Previous treatment consisted of additive hormones in 29 patients, oophorectomy in 8, and chemotherapy in 32. Among the 37 patients evaluable for response and toxicity, 5 objective responses (16.2%) and 20 stable diseases (54%) were noted. Toxicity, absent in 23 patients (62.1%) and mild in 14, consisted mainly of Grade I (WHO) nausea, drowsiness, cutaneous rash, and dizziness. Responders and patients with stable disease experienced a similar survival (median not reached at 22 months). Aminoglutethimide at low doses appears to be beneficial in patients refractory to conventional therapies even if the objective response rate is low.

Adult↗
PubMed1989

[Hyperbaric oxygenation: physical and physiological premises, clinical uses, review of the literature].

The physic and physiologic principles regarding the mechanism of hyperbaric oxygen are referred. On the basis of the literature, the possible clinical applications of hyperbaric oxygen therapy in plastic surgery are reported. The Authors underline the usefulness of this method in traumatic lesions of the legs, in gaseous gangrene, in ulcers of different etiology, in X-rays lesions, in burns and in improving the viability of cutaneous flaps.

Burns↗
PubMed1989

[Congenital metatarsus varus].

The authors report on "congenital primitive metatarsus varus". After discussing the incidence, etiology, pathogenesis and classification, the clinical features and associated malformations are evaluated. Then they go into treatment details affirming, according to the literature, that this malformation is susceptible to complete regression if treated bloodlessly during the early months of life, and in any case, before the onset of loss of ambulation, by manipulations followed by a series of plaster casts and finally by corrective braces and shoes. If this treatment is fruitless or in cases seen at an advanced age and with a high degree of varus, there are several surgical operations that achieve satisfying results operating on tendons or on articular capsules.

Child↗
PubMed1989

[Hypokinetic cardiomyopathy. A possible result of myocardial contusion].

Myocardial contusion is a frequent complication of blunt chest trauma. Ventricular involvement is generally segmental and exhibits a favourable evolution. We describe the case of a 44-year-old male who suffered an acute blunt thoracic injury with a consequent stable worsening of his functional class. His first electrocardiographic examination 30 days after the trauma showed negative T wave in V3-V6 leads while one and two-dimensional echocardiography exhibited a diffuse damage of the morphology of the left ventricle and a lowering of the fractional shortening (FS) of its end-diastolic diameter (EDD): FS = 23%, EDD = 6.9 cm, diastolic eccentricity index = 65%, systolic eccentricity index = 70%. During a follow-up period of thirteen months ECG became normal after a short time while the echocardiogram maintained its initial abnormalities and the patient maintained his compromised functional class. We report this peculiar pattern of myocardial contusion evolution which has not previously been described.

Adult↗
PubMed1989

Zosteriform porokeratosis: a report of two cases.

The authors describe two cases of zosteriform porokeratosis occurring in two female patients, aged seventeen and fourteen years. In both patients the dermatosis was localized to the thigh; one patient also presented with linear lesions in the thoracoabdominal and dorsal regions. Histopathologic examination confirmed the clinical diagnosis and excluded the presence of atypical cells.

Adolescent↗
PubMed1988

Cutaneous metastases from laryngeal carcinoma.

The authors describe a case of cutaneous metastases from a squamous cell carcinoma of the laryngeal vestibule. The skin lesions, which consisted of nodules localized to the forehead and left arm, appeared 2 years after diagnosis of the primary tumor. The skin manifestations preceded lung metastases by 5 months.

Carcinoma, Squamous Cell↗
PubMed1987

Phase II study of esorubicin (4'-deoxydoxorubicin) in locally advanced or metastatic head and neck carcinoma.

Sixteen patients with locally advanced or metastatic head and neck cancer were treated with esorubicin (4'-deoxydoxorubicin) at a dose of 30-35 mg/m2 i.v. every 3 weeks. One patient was lost to the follow up after one cycle, whereas in the 15 evaluable cases a total of 34 courses were administered (median per patient: 2, range: 1-6). Pretreatment for parameter lesions consisted of radiotherapy in 5, chemotherapy in 3 and both treatments in 1 patients respectively. Overall, one partial response, one stable disease and 13 progressions were documented. Severe (grade 3 and 4) leukopenia, thrombocytopenia and anemia were noted in 3, 1 and 1 patients respectively. The only patient developing leukopenia and thrombocytopenia of grade 4 subsequently died because of pneumonia. On the other hand, non-hematologic toxicity was generally mild. At this dose and schedule, esorubicin demonstrated an activity less than 20% in head and neck cancer and therefore, no further evaluation is warranted.

Aged↗
PubMed1987

Alternating tamoxifen and medroxyprogesterone acetate in postmenopausal advanced breast cancer patients--short and long term endocrine effects.

The endocrine effects of alternating tamoxifen and medroxyprogesterone acetate have been evaluated in 26 post-menopausal patients with metastatic breast cancer. Endocrine evaluations included the RIA determination of plasma levels of sex-hormone binding globulin, follicle-stimulating hormone, luteinizing hormone, estradiol, prolactin, cortisol, and testosterone. The evaluation of the study parameters at different intervals during therapy indicates that with this schedule an alternate sequential effect on the endocrine system is achievable because each drug exerts its own endocrine activity that is completely reversed when the other drug is administered. We can hypothesize that the same alternate activity as seen on the endocrine system could be obtained also on other tissues and organs including tumors.

Breast Neoplasms↗
PubMed1987

Sequential combination of tamoxifen and high dose medroxyprogesterone acetate: therapeutic and endocrine effects in postmenopausal advanced breast cancer patients.

A sequential combination of tamoxifen and medroxyprogesterone acetate has been evaluated in 42 postmenopausal untreated patients with metastatic breast cancer. Patients received tamoxifen 10 mg b.i.d., days 1-14, followed by medroxyprogesterone acetate 500 mg b.i.d., days 15-28, orally in an alternating sequence until progression. Twenty-two out of 40 evaluable patients showed an objective response to treatment (55%, 95% confidence limits 38-75%). A significantly higher response rate was observed in patients with age greater than or equal to 70 years, with soft tissue dominant lesions and with only one metastatic site. Median time to progression was 41 weeks and the median survival time 88 weeks. In 4 cases treatment was discontinued because of severe toxicity while in the remaining patients no toxicity (20 patients) or mild side effects (17 patients) have been observed. After 2 months of therapy, this combination showed a progestogenic effect on the endocrine parameters inducing a significant decrease of SHBG, gonadotropins, testosterone and cortisol. These preliminary clinical results and the moderate toxicity of the sequential combination support the need to further investigate this approach.

Adult↗
PubMed1987

Cisplatin and 5-fluorouracil combination chemotherapy in advanced and/or metastatic colorectal carcinoma: a phase II study.

The possible synergism of cisplatin (P) and 5-fluorouracil was studied in 38 consecutive patients with advanced or metastatic colorectal carcinoma. Cisplatin 60 mg/m2 i.v.q. 4 weeks and fluorouracil 600 mg/m2 i.v. weekly were administered for at least 2 cycles, on an out-patient basis, to 24 males and 14 females with a median age of 57 years and a median PS of 80 (Karnofsky). Evaluable lesions were: primary unresectable tumor in 2 patients, local recurrence in 11, liver, lung, bone and soft tissue metastases in 21, 7, 2 and 3 patients respectively. With a median number of 3 cycles administered to 35 evaluable patients, 6 partial responses, 16 unchanged and 13 progressions were observed. Responses were observed in the liver (2 patients), lungs (1) and soft tissues (3). Median remission duration was 15 weeks, median duration of 'unchanged' was 12 weeks. The overall median survival was 24 weeks (30.5 weeks for responders and 22.5 weeks for non-responders). Six patients were pretreated with chemotherapy not containing cisplatin (mainly adjuvant 5-FU). None of them responded. Toxicity was very tolerable with moderate nausea, vomiting and alopecia in the majority of the patients; bone marrow toxicity was generally mild with no blood transfusions required, no complications of myelosuppression (sepsis or bleeding) and no chemotherapy-related deaths. In this experience the combination of low dose cisplatin with fluorouracil, does not appear to significantly enhance 5-FU toxicity and the response rate is not superior to that reported with 5-FU alone. However, better designed schedule combinations with optimal doses, sequences and exposure time of the 2-drug regimen, seem necessary to obtain the biochemical events that support the potentiation.

Adenocarcinoma↗
PubMed1987

Circumscribed spontaneous heterotopic ossification in the soft tissues simulating sarcoma.

Eight cases are described of circumscribed heterotopic ossification in the soft tissues characterised by spontaneous onset, no history of trauma, and rapid course which have frequently led to a mistaken preoperative diagnosis of highly malignant tumour. The terminology differentiates it from myositis ossificans, which is a different entity. The authors emphasize the need for accurate evaluation of all the clinical and radiographic data in order to avoid an erroneous diagnosis of extraosseous osteogenic sarcoma or parosteal osteogenic sarcoma. In this regard, both radiography and histological examination demonstrate the so-called zoning pattern, namely a radiolucent central zone corresponding to the more immature area and consisting of fibrous tissue with active histiofibroblastic proliferations and a radiopaque peripheral area, where ossification is more mature the closer it gets to the periphery. Histological specimens obtained exclusively from the central area may lead even the most expert pathologists to a diagnosis of fibrosarcoma or osteogenic sarcoma. Finally, the pathogenetic aspects of the anomaly are discussed, as well as those concerned with the differential diagnosis from other types of heterotopic ossification.

Adolescent↗
PubMed1987

Combination of amikacin and ceftazidime as empiric treatment of febrile leukopenic patients affected by solid tumors.

A combination of amikacin and ceftazidime was used as initial empiric therapy for the treatment of 25 evaluable febrile episodes (temperature greater than or equal to 38.5 degrees C) in leukopenic adult patients (wbc less than or equal to 1,000/mm3) with solid tumors, characterized by poor prognosis because of low performance status (median Karnofsky score: 50) and progressive disease (76% of cases). Nineteen (76%) of the 25 episodes responded to the initial empiric antibiotic combination. In the microbiologically documented infections, there was no significant difference in the response rate between bacteremia (67%) and localized infections (81%). The response in localized infections caused by gram-negative organisms (81%) was similar to that obtained in gram-positive organisms (82%), whereas gram-positive bacteremia responded better than gram-negative (100 vs 50%). No serious side effects were observed. Reversible nephrotoxicity occurred in 12% and hypokalemia in 20% of the patients treated. This antibiotic combination is a safe and efficacious empiric therapy for infections in leukopenic patients with solid neoplasia.

Adult↗
PubMed1987

Doxorubicin distribution in human breast cancer.

Using a high-performance liquid chromatographic method coupled with fluorimetric detection, we evaluated plasma pharmacokinetics of doxorubicin (DX) and tissue distribution in seven patients suffering from locally advanced breast cancer. Tumor biopsies were performed 30 minutes and 24 hours after DX injection. In addition at 48 hours, during surgery, biopsies were obtained from primary breast cancer, nodes, and other accessible tissues, and DX concentrations were analyzed. A triexponential equation gave the best fit for plasma levels and the values (mean +/- SE) were: elimination half-life, 37.6 +/- 4.9 hours; volume of distribution, 605 +/- 61 L/m2; and clearance 200 +/- 27 ml/min/m2. There was greater interindividual variability in tumor DX concentrations than in plasma concentrations. DX reached much higher (range at 48 hrs, 1.54-14.17 micrograms/g) and longer-lasting concentrations in tumor than in plasma. At 48 hours tumor concentrations were 55.2-337.4 times the plasma concentrations. DX concentrations in normal breast were lower or similar to those in breast carcinoma. DX levels were very low in fat and skin, slightly higher in muscle, and very high in normal or metastasized lymph nodes.

Breast Neoplasms↗
PubMed1986

Cardiac arrhythmia: possible complication from treatment with cisplatin.

Cardiotoxicity is rarely observed during cisplatin chemotherapy. A possible synergistic toxic effect of cisplatin with etoposide on cardiac electrical activity is discussed. A case of a 60-year-old woman with squamous cell lung carcinoma who developed paroxysmal supraventricular tachycardia during cisplatin chemotherapy is reported. The potential cardiotoxicity should be considered when cisplatin is combined with other cardiotoxic agents or used in patients with cardiac disease.

Arrhythmias, Cardiac↗