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Biomedical subjects

G Mele

Publications and source records attributed to G Mele.

At least 37 records · Page 2Linked to original sources
PubMed1998

Spontaneous splenic rupture in a patient with acute lymphoblastic leukemia of Burkitt type.

We describe a case of spontaneous splenic rupture occurred in a patient with acute lymphoblastic leukemia of Burkitt type before starting cytotoxic chemotherapy. Left hypochondrial pain radiating to the homolateral shoulder was the only clinical symptom. Emergency computed tomography showed splenic laceration and hemoperitoneum. The patient underwent immediate laparatomy with splenectomy and experienced an uneventful postoperative recovery. Eight days after surgery, chemotherapy could be administered and complete remission was achieved. Although spontaneous rupture of the spleen is rare in leukemia and related disorders, this diagnosis should be taken in account also when clinical symptoms are mild. Following immediate operative management, patients may completely recover and receive cytotoxic chemotherapy with substantial possibilities of achieving complete remission.

Abdominal Pain↗
PubMed1998

Therapeutic options and treatment results for patients over 75 years of age with acute myeloid leukemia.

BACKGROUND AND OBJECTIVE: Acute myeloid leukemia (AML) is a prevalent disease of the elderly. Given the progressive aging of the general population, the frequency of the disease will further increase, especially in very old individuals. In a cohort of 70 consecutive AML patients aged over 75 years, we investigated the clinico-hematological characteristics and treatment results. DESIGN AND METHODS: Seventy patients aged > 75 were diagnosed at our institutions as having AML between January 1987 and December 1996. This figure represents 8% of the whole AML patient population observed during the same period. These patients were studied concerning the main clinical and hematological features at presentation, therapeutic approach and clinical outcome. RESULTS: A myelodysplastic syndrome preceded the onset of AML in 10 patients (14%). Trilinear myelodysplasia was present in 28 patients (40%). Hypocellular leukemia was diagnosed in 12 cases (17%). An active infection was found in 12 patients (17%). Aggressive chemotherapy was given to 22 patients (31%), low-dose ARA-C (LDARA-C) to 7 patients (10%), while 41 (58%) were managed with supportive care and/or hydroxyurea (HU). Therapeutic choice was significantly influenced by performance status (p = .03), infections (p = .0001), severe co-morbid disease (p = .0001), and hypocellular AML diagnosis (p = .0001). Complete remission (CR) was obtained in 7/22 patients aggressively treated (32%), 0/7 in the LD-ARA-C group, and in one patient treated with HU. The median survival for the whole patient population was 18 weeks. There was no significant difference among the three treatment groups. However, patients achieving CR experienced significantly longer survival as did those with hypocellular leukemia. INTERPRETATION AND CONCLUSIONS: In spite of a relevant selection at diagnosis, intensive chemotherapy is not appropriate for the majority of very old patients with AML. However, since a minority of patients takes substantial advantage from an aggressive approach, any effort should be made to preliminarily identify this subset at diagnosis.

Acute Disease↗
PubMed1997

Circadian performance of suprachiasmatic nuclei (SCN)-lesioned antelope ground squirrels in a desert enclosure.

Circadian activity parameters of 53 white-tailed antelope ground squirrels, Ammospermophilus leucurus, were measured to determine the role of the suprachiasmatic nuclei (SCN) pacemaker in their health and survival. Wheel-running activity was monitored in the laboratory with 44 individuals to document the presence of free-running circadian rhythms and ability to entrain to light-dark cycles. Twenty-two individuals were returned to the desert site of origin, including 12 intact control animals and 10 animals whose circadian timing had been disrupted by SCN-lesioning. Time of activity was recorded continuously for 15 days in a large outdoor enclosure by a motion detector, a microchip transponder detector, and video surveillance. An unplanned nighttime attack by a feral cat resulted in the death of 60% of the SCN-lesioned animals and 29% of the control animals in the enclosure. Surface activity of SCN-lesioned animals at the food cache occurred both in daytime and at night, ranging from 16.0% nighttime activity for one partially lesioned individual to 52.1% for one completely lesioned animal. Controls were strongly day-active, with nighttime surface trips constituting only 0-1.3% of all excursions to the cache. Nine wild free-ranging individuals, including one with a radiotransmitter collar, were exclusively day-active. One of the functions of the SCN in mammals may be to reduce activity of animals during times that are unfavorable for activity.

Animals↗
PubMed1995

Effects of housing density on mouse physiology and behavior in the NASA Animal Enclosure Module simulators.

Space flight studies using the Animal Enclosure Module (AEM) make it possible to investigate the role of microgravity on animal physiology and behavior. In this study, we compared the health and well-being of mice housed at different densities in AEM simulators (AEMS), to vivarium shoebox (control) cages (VSBC). A stress assessment battery (SAB) of measures was developed to evaluate mouse health and well-being, and to determine if any of the population sizes resulted in a stressful environment. The SAB was based, in part, on recommendations of a NASA Workshop on Rodent Cage Sizing. It includes: 1) General assessment of appearance, 2) Behavioral assessment (video), 3) Food and water consumption, 4) Body weight changes, 5) Thymus, adrenal, spleen, heart and kidney weights, 6) Plasma corticosterone concentration, 7) Total plasma protein concentration, 8) Total blood leukocyte count, 9) Differential leukocyte count: neutrophil/lymphocyte ratio; eosinophil count, 10) Gastric histology.

Animals↗
PubMed1993

Recombinant interferon alpha-2b in the treatment of polycythemia vera.

We studied the effects of recombinant alpha 2-b interferon (alpha 2-b IFN) in a dose of 3 x 10(6)U intramuscularly three times a week for 1 year in 13 patients affected by polycythemia vera (PV) previously treated with phlebotomy only. Response to treatment was evaluated by reduction of the number of phlebotomies required to retain normal hematocrit value. Ten out of 13 patients (77%) responded to treatment; in 4 of them the exigency of phlebotomy was completely eliminated. In all responders a concomitant decrease of platelet count and splenomegaly was obtained. Treatment was well tolerated and side effects were easily controlled. We conclude that alpha-IFN may represent an attractive therapeutic option in the management of the proliferative stages of PV.

Adult↗
PubMed1993

New findings regarding light intensity and its effects as a zeitgeber in the Sprague-Dawley rat.

Circadian rhythmicities are oscillations of physiological cycles designed to create temporal organization. Circadian rhythms ensure that physiological mechanisms are expressed in proper relationship to each other and the 24 hour day. Light is the main zeitgeber ("time giver") for biological clocks. The daily variations in light intensity from dawn to dusk, and seasonally due to the rotation of the earth, act upon organisms to give them photoperiodic information. This entrainment allows them to vary biologically to prepare for reproduction, hibernation, migration and the daily adaptations necessary for survival. In most mammals, the suprachiasmatic nucleus of the anterior hypothalamus has been implicated as the central diving mechanism of circadian rhythmicity. The photic input from the retina, via the retino-hypothalamic tract, and modulation from the pineal gland help regulate the clock. In this study we investigated the effects of low light intensity on the circadian system of the Sprague-Dawley rat. A series of light intensity experiments were conducted to determine if a light level of 0.1 Lux will maintain entrained circadian rhythms of feeding, drinking, and locomotor activity.

Activity Cycles↗
PubMed1992

Clinical relevance of immunological dissection in T-ALL: a report on 20 cases with stem cell (CD7+, CD4-, CD8-, CD1-) phenotype.

In a prospective study on 44 cases of T-cell origin acute lymphoblastic leukemia, 20 patients were found to display an immature immunophenotype (CD7+, CD4-, CD8-, CD1-) and were classified as T-stem cell leukemia (T-SCL). Twenty-four patients expressed CD4 and/or CD8 antigens on their blast cells, designated T acute lymphoblastic leukemia (T-ALL). The T-SCL subset showed a significantly higher median age, a more frequent incidence of extramedullary leukemia, a morphology L1 in most cases, and a poor response to treatment in terms of either complete remission rate or median survival duration. In addition, significant differences between the two groups were found in evaluating the number of days of blast disappearance from peripheral blood, of CR achievement, and of neutrophils and platelets recovery. We conclude that T-SCL represents a distinct clinical entity, characterized by a poor response to ALL conventional chemotherapy. Alternative therapeutic approaches should be developed for patients suffering from this form of leukemia, to modify its severe prognosis.

Adult↗
PubMed1992

Recombinant interferon-alpha 2A as maintenance treatment for patients with advanced stage chronic lymphocytic leukemia responding to chemotherapy.

Forty-five patients suffering from advanced B-CLL were randomized to receive interferon-alpha (IFN alpha) or no treatment after achieving complete remission or partial response, following a chemotherapy protocol called MiNa. The two groups were fully comparable in terms of clinical characteristics and level of response obtained by chemotherapy. IFN alpha was given at a dose of 3 megaunits three times a week intramuscularly for 1 year. The IFN-treated patient group showed a significantly longer duration of response and a less frequent incidence of infections as compared to the no treatment group. A minority of patients who had had partial response to chemotherapy obtained complete remission while on therapy with IFN alpha. Toxicity was mild and patient compliance was excellent. We conclude that IFN alpha may have a role as maintenance therapy in CLL for patients responding to chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Post-marketing survey of nimesulide in the short-term treatment of osteoarthritis.

A multicentric trial was carried out to assess the therapeutic efficacy and tolerability of nimesulide in the treatment of patients with osteoarthritis. The trial involved 1600 general practitioners, 80 orthopedists and 88 specialists in internal medicine. A total of 22,938 ambulatory patients was admitted to the trial. Patients were given nimesulide tablets (40%) or granules (60%) from 100 to 400 mg/day for a length of time ranging from 1 to 3 weeks. The treatment was effective in relieving spontaneous pain and morning stiffness. The level of patients with adverse reactions, presumably related to nimesulide and mostly involving the gastro-intestinal tract, was 8%. The results of this study suggest that nimesulide is effective and well tolerated in the short-term treatment of a large number of patients with osteoarthritis.

Adult↗
PubMed1990

Myeloid antigen expression in adult acute lymphoblastic leukemia: clinicohematological correlations and prognostic relevance.

Fifty adult patients with acute lymphoblastic leukemia (ALL) were prospectively studied to determine the clinical and hematological relevance of surface immunophenotypes. Before treatment, blast cells were assayed for reactivity to monoclonal antibodies to B-cell, T-cell, and myeloid (My) antigens. My antigens (CD13, CD33, and VIM2, singly or in combination) were demonstrated in 16 cases (32%) along with lymphoid specificities. Bone marrow and peripheral blood stains were classified according to French-American-British (FAB) Cooperative Group criteria and evaluated for myelodysplastic changes and azurophilic granules. Mean age of My+ patients was significantly higher. Furthermore, a greater number of My+ cases showed azurophilic cytoplasmic granules and acid ANAE positivity. FAB subtypes and myelodysplastic features did not significantly differ in the two groups analyzed, but patients with myelodysplastic abnormalities represented a significantly older age group. Response to treatment was comparable in My+ and My- cases, in terms of either complete remission rate or median survival duration.

Adult↗
PubMed1989

A new combination chemotherapy for advanced chronic lymphocytic leukemia (vincristine, cyclophosphamide, melphalan, peptichemio, and prednisone protocol).

The MiNa protocol (vincristine, cyclophosphamide, melphalan, peptichemio, and prednisone) was given to 20 patients with advanced B-cell chronic lymphocytic leukemia. Complete remission (absence of all clinical and bone marrow evidence of leukemia) was obtained in 35% of cases; partial response (greater than 50% reduction in organ enlargement and decreasement of lymphocyte count to less than 15(9) X 10/l) was observed in 35% of patients. Of 12 patients (60%) previously treated with chlorambucil and corticosteroids, nine responded to treatment. Toxicity was mild and the relapse rate particularly low. It was concluded that the MiNa protocol represents an effective chemotherapy for advanced and/or progressive CLL.

Aged↗
PubMed1988

Antibiotic prophylaxis for abdominal hysterectomy.

Three different regimens of antibiotic treatment have been employed in order to evaluate their efficacy as a profilaxis for abdominal hysterectomy. Two short term administrations (Cephtriaxone and Cephamandole plus Tobramycine) and a conventional full dose treatment (Cephazoline) have been compared over a group of homogeneous patients. No significant differences, except a reduction in postoperative time spent in hospital, have been found among the groups. A reduction in urinary tract infection has also been reported with a single-dose antibiotic prophylaxis.

Anti-Bacterial Agents↗
PubMed1987

[Diacereine: an original approach in the treatment of degenerative and/or extra-articular rheumatism].

71 patients with variously located osteoarthrosis or primary fibromyalgic syndrome were treated with oral diacereine (DAR). The case series was accumulated in successive periods and may be divided into three groups. An "open" test on DAR (100 mg/die for 4 weeks) was conducted on the first group of 31 arthrosis patients. On the second group of 20 other arthrosis patients a "double-blind, cross-over" test was carried out using DAR (100 mg/die) and naproxene (500 mg/die) both for 2 weeks. The third group of 20 patients with fibromyalgia was treated with DAR alone: 100 mg/die 5 days a week for 12 weeks. The efficacy of the treatment was judged on the basis of the following parameters: rest pain, pressure pain, pain on active and passive movement, and functional limitation. In the first group a positive therapeutic effect was noted in 20 cases (68.9%). There were side effects (moderate diarrhea) in 3 patients 2 of whom suspended treatment. In the second group, DAR and naproxene had an almost identical effect. However 7 patients (36.8%) expressed a preference for DAR, 9 (47.4%) expressed no preference and only 3 (15.8%) preferred naproxene. Side effects were encountered in 3 patients treated with naproxene (2 cases of epigastralgia and pyrosis and 1 case of dyspnea so marked as to require suspension of treatment) and in 3 treated with DAR (modest diarrhea). In the third group, a positive therapeutic effect was noted in 68.4% of the patients with fibromyalgia with a 15% incidence of side effects consisting of slight abdominal pain (diarrhea caused suspension of treatment in 1 case only). Blood chemical parameters were studied in all three groups and no alterations attributable to the treatment were found. The obtained result suggests that the new drug is effective and well tolerated in the envisaged indications.

Administration, Oral↗
PubMed1987

The coexistence of rheumatoid arthritis and systemic lupus erythematosus.

A 29-year-old white female with longstanding classical rheumatoid arthritis (RA) developed clinical and serological manifestations of systemic lupus erythematosus (SLE) with prominent signs of diffuse proliferative lupus nephritis. She fulfilled the ARA criteria for the classification of SLE as well as the ARA criteria for classical RA. The concomitant presence of these two affections in the same patient is rare and the discriminating features suggest that this coexistence may be coincidental. With respect to treatment, our patient had good relief of symptoms by a combined administration of methylprednisolone pulses and cyclophosphamide.

Adult↗
PubMed1987

Effectiveness and tolerability of ketoprofen lysine, once a day, in patients with rheumatic disorders.

Ketoprofen lysine (KL) at a dose of 160 mg b.i.d. has been shown to have favourable anti-inflammatory and analgesic properties in a large number of patients. In the present paper investigators describe their experience with a new therapeutic schedule of KL, 320 mg given once a day to patients with various rheumatic disorders. With this new schedule there was satisfactory clinical improvement of most of the clinical parameters and good tolerability, with a low incidence of gastric troubles. The favourable clinical effects and the patients' good compliance with once-a-day KL make it a useful drug for successful treatment of rheumatic disorders.

Drug Administration Schedule↗
PubMed1987

Detailed ultrasound as a screening method for craniospinal abnormalities.

High resolution diagnostic ultrasound was assessed as a screening method for craniospinal anomalies during the second trimester of pregnancy in a population at low risk for neural tube defects (83,403 mothers). The effectiveness of the test was about 60% and the failure rate mainly due to late attendance. In a subgroup (9325) where the screening purposes were satisfactorily fulfilled, the detection rate (87%) was substantially greater. The significance of the results and the cost/benefit ratio, especially compared with serum alpha-feto protein screening services, are then discussed.

Female↗
PubMed1986

Oxalate depuration during biofiltration with AN69 and in conventional hemodialysis in chronic renal failure (CRF) patients.

Oxalate (Ox), an end product of amino acid metabolism, accumulates in CRF patients as calcium crystal deposits in many soft tissues such as myocardium, kidney interstitium, etc. Since BF employs AN69, a high efficiency membrane, we tested its depurative efficacy for Ox against a hollow-fiber cuprophan dialyzer. Five CRF patients previously in HD and after six months of BF were studied. End-dialysis and pre-dialysis Ox values and dialyzer clearance were obtained. Predialysis Ox values were: 0.44 +/- 0.15 mg/dl in HD and 0.42 +/- 0.09 mg/dl in BF (NS). End-dialysis Ox values were: 0.30 +/- 0.09 mg/dl in HD and 0.22 +/- 0.04 mg/dl in BF (p less than 0.001). Pre and post dialysis values differed by 31% in HD and 47% in BF (p less than 0.001). Ox clearance was 98.8 +/- 10.3 ml/min in HD and 143 +/- 20.5 ml/min in BF. There was a rebound in Ox values at 48 hours (0.41 +/- 0.08 mg/dl in HD and 0.32 +/- 0.12 mg/dl in BF, (NS). These results indicate that Ox is depurated better during BF than during HD.

Acrylic Resins↗