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Biomedical subjects

L Mariani

Publications and source records attributed to L Mariani.

252 records · Page 14Linked to original sources
PubMedDate not supplied

Predictive value of cell kinetics in endometrial adenocarcinoma.

Flow cytometric DNA content and proliferative kinetic markers, S-phase fraction (SPF) and thymidine labeling index (TLI), were evaluated in 68 patients with endometrial carcinoma. A high rate of aneuploid tumors was detected (48.4%); median values of SPF and TLI were 6.4 and 6.2, respectively. No significant relationship emerged between ploidy status and proliferative markers in respect to clinical and pathological variables. Aneuploid tumors had a higher recurrence rate than diploid tumors (21.8% vs 9.6%), but the difference was not statistically significant. According to the median value of both kinetic markers, the study population was divided into low and high-risk, where DFS was 100% and 71.4%, respectively (p = 0.05). Furthermore, high-TLI tumors (> 6.2) had a significantly worse DFS (75.4%) than low-TLI (100%) only among patients assigned to Stage I of the disease, regardless of other pathological variables. At multivariate analysis myometrial invasion resulted as an independent and significant factor. Flow cytometric ploidy analysis was useless as a predictive biological parameter and did not add any further prognostic information to the pathologic variables. SPF and TLI values could indicate a subset of women with unexpected poor outcome in a group of patients generally considered at low-risk, i.e. Stage I. If further investigation confirms these data, it could prove useful for therapeutic planning in endometrial cancer patients. At the present time, pathological and clinical factors are still the most reliable predictive parameters.

Adenocarcinoma↗
PubMedDate not supplied

Factors influencing the indomethacin-induced intestinal lesions in the rat.

The influence of various experimental conditions such as partial hepatectomy, administration of hepatotoxic drugs such as carbontetrachloride or ethionine, and starvation on the ulcerogenic activity of indomethacin at intestinal level has been studied in the rat. While lesions produced by oral administration of high doses of indomethacin are reduced by starvation, the incidence of ulcers was significantly increased by partial hepatectomy and by hepatotoxic drugs reaching the maximum of severity (intestinal perforation) in partially hepatectomized animals. These findings suggest that ulcerogenic activity of indomethacin is strictly correlated to the drug metabolising capacity of the liver.

Animals↗
PubMedDate not supplied

[Cerebral circulation and therapy of hypertensive crises].

The availability of new and more active drugs as well as the progress in emergency medicine have made it possible to deal in new ways with the therapy and management of hypertensive crises. The more aggressive character of this treatment leads us to reconsider the risk/benefit ratio also on the basis of changes brought about by the drugs used in the compensatory cardio-vascular equilibria that have become established in the course of the disease, as well as the possibility, that rapid and intensive pressure reductions bring about phenomena of brain hypoxia to the extent of drug syncope and brain damage. After analyzing phenomena of adaptation of brain circulation to the hypertensive disease, the authors discuss risk factors of therapeutic choices in relation to the mechanism of action of the drugs available and used, to different clinical situations and to the patient's age.

Antihypertensive Agents↗
PubMedDate not supplied

O6-methylguanine and temozolomide can reverse the resistance to chloroethylnitrosoureas of a mouse L1210 leukemia.

Using L1210 and a subline resistance to chloroethylnitrosoureas (L1210/BCNU), we found that the resistance to 1-(2-chloroethyl)-1-nitrosourea (CNU) or to diethyl-1-3-(2-chloroethyl)-3-nitrosoureido ethyl phosphonate (fotemustine) can be reversed by a pretreatment with O6-methyl Guanine (O6-mGua) or temozolomide. In L1210/BCNU but not in L1210 the pretreatment with O6mGua caused an increased peak level of CNU-induced DNA-interstrand crosslinks. We then evaluated whether the resistance to BCNU could be counteracted in vivo by i.p. O6mGua treatment of L1210/BCNU bearing mice. The results were negative due to the fact that O6mGua, which was not toxic when given alone, caused a high toxicity when associated with BCNU.

Animals↗
PubMedDate not supplied

[Problems of pharmacokinetics in pregnancy. A bibliographic review].

Drug prescription in pregnancy for the treatment of maternal diseases and the first attempts to obtain therapeutic effects even on the product of conception make necessary to know the pharmacokinetics of drugs in pregnancy. The Authors discuss how changes of physiological maternal parameters and the presence of the placenta and of the foetus can affect drug pharmacokinetics in a clinically important way. The possibility that the unique multicompartmental structure of the maternal-placental-foetal unit can "trap" drugs in the foetus is highlighted. Methodological, ethical and legal problems make the acquisition of data on these changes difficult, but their knowledge is needed in order to prevent adverse and toxic effects both in the pregnant woman and in the foetus and to attempt a therapy of foetus diseases in intrauterine life.

Amniotic Fluid↗
PubMedDate not supplied

[Effect of glycerol formal on the embryonic development of the rat].

In order to evaluate the effect on embryonic development of a solvent commonly used in pharmacological investigations, glycerol formal was administered to pregnant rats from days 6 through 15 of gestation at the daily doses of 0.25, 0.50 and 1.0 ml/Kg i.m. Glycerol formal did not induce systemic toxicity in the mothers, but showed an embryotoxic and teratogenic activity on the products of conception.

Animals↗
PubMedDate not supplied

Lack of improvement of prognostic performance of weight loss when combined with other parameters.

This prospective study was designed to evaluate the ability of single and combined prognostic parameters in predicting postoperative infections in cancer surgical patients. The evaluation was based on multiple logistic analysis and receiver operating characteristic (ROC) curve analysis. The Younden's index (YI) was used to select threshold values of the parameters. This analysis was applied in 398 patients undergoing curative elective surgery for gastric, colorectal, or pancreatic cancer. At admission, the percentage of body weight loss, serum albumin, total lymphocyte count, total iron-binding capacity, and serum cholinesterase activity were evaluated. In all patients, the type and rate of postoperative infection were recorded. Multiple logistic analysis showed weight loss as the most predictive variable (p = 0.02), when taken individually. Its best cutoff value was 10% (YI = 1.27, p = 0.00001, ROC area = 0.62). When serum albumin was added as the second-best variable, with a threshold of 35 g/L, the combined YI was 1.27, and the ROC area was 0.65 (p NS vs. weight loss). Total lymphocyte count dichotomized at 2200 million/L was the third variable added to weight loss and serum albumin (YI = 1.31, ROC area = 0.59). In conclusion, weight loss split at 10% appears as the only index with a moderate prognostic performance that is worth evaluating in the preoperative nutrition assessment. A nonsignificant improvement of predictive ability was obtained by the combination of serum albumin, total lymphocyte count, total iron-binding capacity, or serum cholinesterase activity.

Cholinesterases↗
PubMedDate not supplied

[The value of the Pap test in the diagnostic approach to HPV infection of the cervix uteri].

HPV infection of the low genital tract is the most diffuse STD world wide. For this reason it's necessary to follow a simple flow chart to reach a correct diagnosis and to practice an adequate therapy. The authors relate on their experience in the management of a group of patients they have observed in a STD clinic. In this group it was executed a diagnostic protocol including Pap test, in situ hybridization, dot blot and histologic examination on tissue biopsies. From the analysis of the obtained data, the authors state that the Pap test is very useful to start in the diagnostic protocol, for it is precise, inexpensive and allows to identify the patients to follow with further diagnostic procedures such as colposcopy and histologic examination, in order to reach an exhaustive diagnosis and to assess the proper therapy.

Adult↗
PubMedDate not supplied

[Gene therapy: reality and expectations].

Chemical and pharmaceutical research have provided physicians with an array of drugs that have beneficial effects on a variety of diseases. Such drugs, however, mostly help in controlling the manifestations of the pathological condition but do not permanently modify the underlying cause. Hence the necessity of new forms of therapy that change drastically the current approach to medical treatment. Gene therapy, with its potential to correct the malfunctioning genes at the origin of variety of diseases, seems to fulfill the requirements of this therapeutic "revolution". The feasibility of such an approach is underscored by the improved knowledge of the molecular mechanism and/or gene defects at the origin of acquired diseases widely spread in the population, and of more rare congenital conditions. The technical advances in molecular biology and genetic engineering achieved in the last ten years, offer the tools necessary to implement such therapeutic interventions. Here we present the approaches currently employed for gene therapy in the context of recent clinical trials. The scientific, ethical and economical implications deriving from a prospective routine use of gene therapy in the clinical setting are discussed.

Female↗
PubMedDate not supplied

[Acute obstruction of the abdominal aorta].

The acute occlusion of abdominal aorta is a rare event that may have severe clinical results. Personal experience in three cases of acute thrombosis treated in emergency surgery are presented. Aorto-iliac thromboendarterectomy, aorto-bifemoral bypass and thrombectomy with Fogarty catheter were performed. In the first case, after the operation, a renal ischemia occurred. The second and the third patient died after seven days and twenty-four hours respectively.

Acute Disease↗
PubMedDate not supplied

[Health care provided by national health services and private insurance].

Italy, as well as other European countries and the USA, is facing the necessity of a radical reform of the National Health Service in the context of more general social reforms. Two types of management, state- or private-funded, are coming under analysis in the attempt to define how to provide effective assistance to all citizens in need. The efficient but restrictive services provided by private insurances are compared here to the somehow inefficient but more supportive forms of care provided by state-financed services. The necessity to implement a cost-effective but well-operating system will most probably rely on a tight linkage between the public and the private care providers. Such mixed forms of Health Services, with the additional help of charities, will be able to provide the essential assistance to all in need, and an effective care to citizens full aware of the necessity to fairly contribute to their personal and community care.

Health Care Reform↗
PubMedDate not supplied

[Pharmacovigilance: education and continuing updating. The role of university institutes].

PURPOSE: Lately, pharmacovigilance (FV) and monitoring of adverse reactions to drugs are a frequent issue of analysis and discussion due the prospective alignment of Italian FV with the European Community (EC) guidelines. DESIGN: Most recent and significant available data have been reviewed. RESULTS: Analysis of the 1988-1994 period shows, even though with differences among the Italian regions, a low number of reports and a low index of interest and concern among Health officers. Three issues are discussed here: 1. The necessity and the modalities to provide specific training in FV to the medical community at large, before and after the academic studies; 2. The potential advantages and feasibility of establishing FV services at regional level, and 3. The necessity to maintain a national FV service that, in close collaboration with the regional offices, analyzes all the available information, determines the course of action and maintains a tight link with the European office. CONCLUSIONS: It is important to consider FV as an essential part of the academic training of medical and scientific operators, a field where universities and professional societies may play quite a significant role. The SSN (Italian Health Service) and the Health Ministry should, in turn, be responsible for organizing and directing the services provided to the territory, with acquisition and maintenance of specifically trained personnel.

Academies and Institutes↗