[On the improvement of insipid diabetes by nicotine].
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Biomedical subjects
Publications and source records attributed to G Moretti.
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The histories of seven patients over the age of 60 years are reported. They all suffered from recurrent and prolonged episodes of confusional state associated with psychic and neurologic manifestations. All episodes were accompanied by the occurrence of periodic lateralized epileptiform discharges (PLEDs) on the EEG, which became normal when the ictal episodes subsided either spontaneously or after administration of diazepam i.v. Although PLEDs may correspond to severe hemispheric lesions, serial computed tomography (CT) scan and laboratory investigations detected significant abnormalities in only one case, that of a patient with a progressive dementing outcome. In the other six patients, follow-up neuropsychological controls indicated moderate impairment of higher cortical functions according to the hemisphere involved by PLEDs. Administration of carbamazepine (CBZ) proved rather effective in preventing the recurrence of the ictal episodes. For its clinical, EEG, and prognostic features, this condition may represent a peculiar nonconvulsive status epilepticus in the elderly.
In young adult life a large proportion of mentally retarded subjects develop psychiatric complications, both severe and mild, whose origin is undoubtedly multifactorial (biological and psychological). A series of 27 subjects (13 male, 14 female; mean age 27.6 years) with IQ ranging from 70 to 40 were studied in our Institute from 1994 to 1995 and followed up 1 and 2 years later. Paykel scale (life events), FACES III (type of family insight), MFFT and Watkin's test (cognitive styles) were used to evaluate all cases. We found that (1) minor disorders prevailed in mild and moderate mental retardation and severe disorders in profound mental retardation; (2) minor disorders were generally determined by psychological and environmental factors although biological ones may have an important role; (3) psychological factors prevailed in young adult life when the subject had to cope with relatively harder tasks, and (4) the prognosis is generally good if proper care is given.
AIMS AND BACKGROUND: The aim of the study was to assess the activity and the toxicity of cisplatin (DDP) and fluorouracil (FU) administered by continuous infusion as neoadjuvant chemotherapy for patients with stage II-IV, M0 squamous cell carcinoma of the head and neck. METHODS: Thirty previously untreated patients were submitted to chemotherapy with DDP (20 mg/m2) and FU (1000 mg/m2), both in continuous infusion for 5 days, repeated every 21 days, for a maximum of 5 cycles. Following completion of chemotherapy, the patients underwent radiotherapy; in some patients surgery was performed immediately after chemotherapy. All patients were monitored for response, time to failure, survival, treatment-related events and toxicity. RESULTS: All patients were evaluated for response; after chemotherapy the complete response rate was 27% and the partial response rate 33%. Twenty-four patients underwent radiotherapy: the overall response rate was 83% (complete response 79%). After a median follow-up of 34 months, the median survival time was 22 months with a median time to failure of 15 months. Acute vascular accidents were the main and unexpected adverse events, with 2 deaths for pulmonary embolism and 1 for stroke. The response rate to the regimen does not seem to be better than that obtained with the standard combination of cisplatin bolus and fluorouracil continuous infusion. The disadvantage of the regimen is that it causes more discomfort for the patient in that it requires hospitalization. CONCLUSIONS: For this reason, we believe that there are no elements for recommending the schedule as neoadjuvant treatment of patients with squamous cell carcinoma of the head and neck or as an experimental arm in a randomized trial.
PURPOSE: A phase II study with ifosfamide in pretreated patients with advanced breast cancer was performed to determine the objective response rate, the toxicity and the feasibility of the regimen. METHODS & STUDY DESIGN: Patients enrolled had advanced breast cancer pretreated with at least one previous regimen of chemotherapy for advanced disease. Treatment consisted of ifosfamide infused at a dose of 2 g/m2 iv in 4 hrs followed by ifosfamide, 8 g/m2 iv in 120 hrs in ambulatory treatment, using a portable external pump system. The total dose of ifosfamide was 10 g/m2; mesna (4 g/m2 iv) was administered mixed with ifosfamide in 120 hrs Cycles were repeated every 3 weeks. Three patients were pretreated with neoadjuvant and 15 with adjuvant chemotherapy. All patients were treated for advanced disease (median number of regimens, 1; range, 1-3): 21 with the cyclophosphamide-containing regimen and 15 with adryamicin. Sixteen patients received one or more lines of endocrine therapy. Fifteen patients had dominant site in viscera, 6 in bone, and only one in soft tissue; 17 patients had more than one site of disease. RESULTS: Twenty-two patients were enrolled and all were assessable for response and toxicity. A partial response was reached in 5 patients (23%; 95% confidence limits 5% to 60%). Hematologic toxicity was the dose-limiting side effect; grade 4 leukopenia occurred in 10 patients (46%). CONCLUSIONS: Considering the response rate obtained in our series of intensively pretreated patients, the results seem to indicate that the regimen is active and could be included among the possible options in the treatment of patients with refractory, poor-prognosis, advanced breast carcinoma.
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Renal lesions are one of the must serious visceral complications of progressive systemic sclerosis: three of the five cases reported died in anuria within a few weeks. A part from this very severe fulminating form, however, cases in which lesions can be demonstrated by pathological examination may produce much milder clinical and biological signs, though still having the same prognostic significance. They can become worse at any moment, either spontaneously, or more often because of other factors such as corticotherapy or pregnancy. A review of the published literature has shown the exact frequency of these lesions and their two principal modes of progression, in both of which the same basic histological changes of proliferation of the intima of the interlobular and preglomerular arteries are found. Kidney function tests can be used to guage the severity and extent of these vascular lesions. It is much more difficult, however, to determine the nature of the initial mechanism causing these lesions. The vascular lesion could be a primary one or may be secondary to an immunological disorder, the exact nature of which has still to be determined.
The authors relate the case of a young North-African man who presented during one month several peripheral thrombophlebitis before a ganglionary tuberculosis of the mediastinum appear. With specific antibiotherapy, the cutaneous lesions disappear and can be so considered as a paratuberculous syndroma.
A case of adrenal cortical adenoma and arterial hypertension is reported. We emphasize interest of scintillation scanning with 131 I 19 iodo cholesterol, worth of routine examination when seeking for these tumors.
For some time a bactericidal activity is recognized by air ionization. Recently it has been demonstrated that while the bactericidal effect of the positive ions is due to physical factors, the negative ions operate either by physical or chemical effects. This depends on the presence of oxygen: negative air ionization consists mainly of oxygen ions with a strong oxidizing effect. Beneficial effects of negative air ionization on human health have been recently demonstrated in several studies. In this research the bactericidal effect of the negative air ionization on some strains of Gram+ and Gram- bacteria has been estimated. Trials with Escherichia coli ATCC and Staphylococcus aureus ATCC strains have been carried out using a point-acting tester as generator of negative oxygen ions. The ion concentration was estimated in 8-10(6) ion/cm3 air at a distance from the source of 0.5 metric. The tests were performed in a special room of the microbiology laboratory, equipped without metal furniture and in absence of people. Suspensions of bacterial cells were spread on a solid medium in Petri dishes and then placed, without cover, under the ion generator, at different distances from the source, for 24 hours. The results show a greater effect of the negative air ions on the Gram- than on the Gram+ cells; the number of colonies of Escherichia coli grown under ionization was estimated to be 15.1 times less than of the colonies grown without ionization, while the growth of Staphylococcus aureus in the same conditions was only 4.5. time less. No contamination of Petri dishes by environmental bacteria has ever been occurred during trials: this could demonstrate a biocidal effect of the negative ionization also on air bacteria.
Thirty-three patients were given cholangiojejunoanastomoses: 13 for benign postoperative stenoses of the biliary tract (BT) with or without lithiasis; five for massive intra and extra-hepatic lithiasis; 15 for malignant stenoses on the upper third of the biliary ways. The 15 patients in Group A were given a muco-mucosal anastomosis and the 18 in Group B extramucosal anastomosis after excision of the excess mucosa on the jejunotomy. In both groups an interrupted suture using fine, slow-absorption thread was employed. Three patients (two from Group A and one from Group B) were excluded from the study due to postoperative filtration of the anastomosis. Transhepatic cholangioscopic monitoring of the healing process on the 15th, 20th, 30th and 40th day showed that while both types of anastomosis were equally secure, the extramucosal suture after excision of excess mucosa produced wider anastomoses and is therefore advisable in all cases of bilioenteric anastomosis (BEA) but especially when the biliary ways are narrow or tendentially thin-walled.
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