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Biomedical subjects

L Balducci

Publications and source records attributed to L Balducci.

At least 127 records · Page 7Linked to original sources
PubMed1985

Staging of lung cancer. A cost-effectiveness analysis.

Previous reports found the 67Ga scan highly accurate in staging lung cancer. In the present study the cost-effectiveness of the 67Ga scan was measured and compared with that of routine tests (radionuclide liver and bone scans, brain CT scan) used to stage lung cancer. In 160 patients, the 67Ga scan had a lower sensitivity, specificity, and negative predictive value than the combination of routine tests in detecting metastatic disease. The 67Ga scan was less accurate than the appropriate routine test in establishing the presence of liver, bone, and brain metastases. In the mediastinum the 67Ga scan was not more accurate than the chest radiograph. The average cost to accurately stage a patient by 67Ga scan was $812.12 and by routine tests was $737.60. The cost for metastatic disease was $1,417.70 by 67Ga scan and $1,287.70 by routine tests. It is concluded that at our institution the use of 67Ga scan to stage lung cancer is not cost-effective.

Bone Neoplasms↗
PubMed1985

Identification of desmosomes in the granular cell tumor. Implications in histologic diagnosis and histogenesis.

Electron-microscopic examination of a malignant granular cell tumor revealed cells with abundant granular and glycogen-containing cytoplasm and eccentric nuclei. Numerous junctional structures including desmosomes were identified between tumor cells which, moreover, displayed a pattern of gland formation with the presence of short microvilli in one pole of the cell. The presence of junctional structures may provide a feature for positive identification of this tumor by electron microscopy. The findings may also have implications to further our understanding of the histogenesis of this tumor. This case further raises the question of familiar occurrence of this tumor.

Adult↗
PubMed1985

Extrapulmonary small cell cancer of the retroperitoneum.

Small cell cancer is common in the lung, but may also be found in extrapulmonary sites, given the widespread distribution of the APUD cell, from which this tumor originates. We believe this is the first report of a small cell cancer in the retroperitoneum. An initial good response of the tumor to chemotherapy was followed six months later by appearance of metastases and patient's death. This clinical behavior is usual in extrapulmonary small cell cancer.

Aged↗
PubMed1984

Toward a behavioral assessment of anticipatory symptoms associated with cancer chemotherapy.

A tripartite assessment of nine patients experiencing either pretreatment nausea and vomiting, pretreatment nausea or posttreatment nausea and vomiting only was conducted. Three consistent patterns of response emerged: (1) patients with pretreatment nausea and vomiting reported elevated levels of nausea and anxiety and demonstrated increased levels of physiological arousal; (2) patients with pretreatment nausea reported elevated levels of nausea and anxiety but showed no evidence of increased physiological arousal; and (3) patients with posttreatment symptoms only evidenced low levels on all measures. These data are consistent with the hypothesis that a continuum of responses exists in patients undergoing chemotherapy ranging from no pre- or posttreatment symptoms to pretreatment nausea and vomiting.

Adolescent↗
PubMed1984

Pure red blood cell aplasia associated with paraproteinemia: in vitro studies of erythropoiesis.

Pure red cell aplasia (PRCA) and monoclonal gammopathy were detected simultaneously in a 57 year old man with severe anemia. While erythroid burst forming units (BFU-E) were absent from blood, his bone marrow contained a high normal number of BFU-E in the absence of morphologically recognizable erythroid precursors. Serum from the patient did not inhibit the growth of BFU-E from normal blood suggesting that his PRCA was not antibody mediated. These studies suggest that in the patient the inability to produce erythrocytes was due to a block in the maturation of BFU-E; however, they do not indicate an etiology for this block. The absence of blood BFU-E and their abundance in the marrow may result from selective trapping of these cells by the marrow-blood barrier.

Blood Transfusion↗
PubMed1983

Acute leukemia and infections: perspectives from a general hospital.

The incidence and etiology of infections in 210 acute leukemics at the University of Mississippi Medical Center between 1962 and 1978 were reviewed. Infections episodes occurred 269 times in 148 patients. In 193 infections, potential pathogens were cultured. Infection was a contributing cause of death in 89 patients. E. Coli, S. aureus, K. pneumoniae, and P. aeruginosa accounted for 58% of the isolates. No unusual patterns of antimicrobial resistance were observed. The outcome of the infections was related to the absence or resolution of neutropenia. Among 48 patients febrile on first admission, four cases of gram-negative pneumonia, two cases of fungal pneumonia, and two cases of pseudomonas cellulitis were diagnosed. We conclude that the etiology of infections was similar to that of cancer centers; multidrug-resistant gram-negative organisms were not prevalent; absence or resolution of neutropenia indicates a good prognosis for outcome of infection; and untreated acute leukemics may acquire opportunistic infections.

Acute Disease↗
PubMed1983

Adriamycin versus adriamycin plus cis-diamminedichloroplatinum (DDP) in advanced transitional cell bladder carcinoma. A Southwest Oncology Group study.

Patients with advanced transitional cell bladder carcinoma were randomized to receive either adriamycin alone, or adriamycin plus DDP. Overall response (CR + PR) was 8/41 (19%) for adriamycin alone versus 16/37 (43%) for the combination (p = 0.02). Median response duration was 14 weeks for adriamycin versus 25 weeks for the combination (p = 0.17). Median survival was 28 weeks on adriamycin versus 31 weeks on the combination (p = 0.82). Median survival of responders was 43 weeks, and for patients with stable disease it was 29 weeks. This was significantly better than for those with increasing disease at 15 weeks (p = 0.02). Increased frequency of leukopenia and gastrointestinal toxicity were seen with the combination. Cardiotoxicity and nephrotoxicity were not prohibitive.

Carcinoma, Transitional Cell↗
PubMed1983

High proliferation of granulocyte-macrophage progenitors in tumor-bearing mice.

Cancer may affect hemopoiesis by altering the proliferative status of hemopoietic progenitor cells. In Lewis lung carcinoma (LLC), the proliferative rate of the granulocyte-macrophage colony-forming unit (culture) (GM-CFUc) was studied using in vivo hydroxyurea techniques. The disposal of mature elements to the periphery was also monitored during tumor growth. Neutrophilia, anemia, and splenic hypertrophy developed during the course of the disease. By Day 6 post-tumor implant, myeloid hyperplasia of the marrow was evident, but the content of GM-CFUc in LLC mice was similar to that of control. However, by Day 11, the marrow of LLC mice displayed an increased concentration of GM-CFUc, which tripled by Day 19. There was an increased percentage of proliferating GM-CFUc in LLC mice by Day 6 which was highest by Day 11 and thereafter declined. The level of colony-stimulating activity was higher in the serum of tumor bearers than in that of controls. The early increase in proliferative rate of these early hemopoietic precursors can account for the later accumulation of GM-CFUc and myeloid elements in the marrow. Increased cycling of hemopoietic stem cells raises questions concerning the potential for early exhaustion of hemopoietic progenitor cells in these animals.

Animals↗
PubMed1982

Cisplatin hydration with and without mannitol diuresis in refractory disseminated malignant melanoma: a southwest oncology group study.

In a prospective phase II randomized trial, a dose of 100 mg/m2 iv cisplatin every 3 weeks plus forced hydration with or without mannitol diuresis was tested in patients with previously treated advanced malignant melanoma. A total of 67 patients were evaluated: 33 not given mannitol and 34 in the mannitol arm. Two partial remissions (of 2+ and 6.5 months) were achieved in the no-mannitol arm and one complete response and four partial responses (of 1, 2, 2.5, 5.5, and 8 months) were seen in the mannitol arm. Moderate, severe, and life-threatening renal toxicity was less in the mannitol arm, and patients tolerated more doses of cisplatin. The renal toxicity occurred mostly after the first dose of chemotherapy and did not seem to be cumulative. Other side effects were comparable in both arms. We concluded that renal toxicity is less severe in patients treated with cisplatin, hydration, and mannitol and that the use of cisplatin alone or in combination with other active agent(s) should be considered for further evaluation in previously untreated patients with malignant melanoma.

Cisplatin↗
PubMed1981

Neurological and electroencephalographic abnormalities after febrile seizures. Possible association with cytomegalovirus.

In order to assess the possible association of cytomegalovirus (CMV) with cerebral damage, 65 children aged between 2 and 10 years were tested for CMV isolation and antibody status. All of them had previously presented one or more episodes of febrile convulsions. At the time of our study, they were grouped according to their clinical features and electroencephalogram (EEG). 21 had typical and/or atypical absence attacks with 3 c/s spike-wave EEG (primary generalized epilepsy), 21 presented febrile seizures and spontaneous fits with focal EEG abnormalities, 23 had no seizures and a normal EEG. We performed the same investigation in 41 healthy children. The study showed a similar isolation rate of CMV in healthy subjects and in patients without neurological and EEG alterations, while a significantly higher isolation rate was observed in the groups with neurological and EEG abnormalities. As for serology, no significant difference was observed between the four groups, although the positivity rate of the healthy children was lower than in the other three groups. The study suggests a possible association of CMV with neurological and EEG abnormalities after febrile seizures.

Antibodies, Viral↗