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Biomedical subjects

M Ferrara

Publications and source records attributed to M Ferrara.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Treatment of refractory metastatic breast cancer with 5-fluorouracil and levofolinic acid as 48 hours continuous venous infusion.

Twenty-four consecutive patients with metastatic breast carcinoma (MBC) refractory to first line chemotherapy were treated with high-dose folinic acid (FA) 100 mg/m2 diluted in 250 cc of normal saline as 2 hour infusion followed by 5-fluorouracil (5FU) 400 mg/m2 bolus then 5FU 600 mg/m2 as continuous infusion for 22 hours. This therapy was repeated for 2 consecutive days. Chemotherapy was repeated every 15 days. All enrolled patients were evaluable for objective response. A complete response was achieved in 1 patient (4%) and a partial response in 6 cases (25%) for an overall response rate of 29% (confidence limits 18%-39%). The median duration of objective responses was 8.4+ months (range 3.0+/12.8). Six patients showed no change (25%) with a median duration of 4.0 months 11 patients progressed (46%). A subjective improvement in tumor-related symptoms was reported by all responding patients and in 3 patients with no change. Most patients (7/10) with symptomatic bone lesions had a subjective improvement with reduction in analgesic drugs consumption. Objective responses were observed at all sites of disease. In fact, responses were seen in the skin liver lung bore and rodal metastases. The median overall survival was 13.0+ months (range 4.0/16.2+). Over a total of 160 cycles (a mean of 6.6 cycles/patient) grade 1-2 leukopenia was seen in 9 patients (37%) grade 1 thrombocytopenia in 4 patients (17%) and grade 1 anemia in only 2 cases (8%). Grade 3-4 leukopenia or thrombocytopenia were not seen. Phlebitis at the injection vein occurred in 3/10 patients (30%) which refused to implant a central line. In patients with a central line or a port-a-cath no cases of vascular, toxicity were seen. Gastrointestinal toxicity was very mild with 9 patients (37%) suffering from grade 1-2 nausea/vomiting 6 patients (25%) complaining of grade 1-2 diarrhea and 6 patients with grade 1-2 stomatitis. Hand-foot syndrome was observed in only 1 patient. No cases of grade 3-4 gastrointestinal toxicities have been, observed. No cases of cardiotoxicity and/or neurotoxicity were recorded. The combination of high-dose FA and 5FU given as 48 hour continuous venous infusion every 2 weeks is active, at least in terms of objective response rate and tumor-related symptoms palliation against anthracycline-refractory MBC. These results compare favorably with bolus administration of FA and 5FU or other salvage regimens.

Adult↗
PubMedDate not supplied

Treatment of refractory metastatic breast cancer with 5-fluorouracil plus levofolinic acid as continuous venous infusion: a phase II study.

Effective palliation of metastatic breast carcinoma (MBC) after the failure of front-line chemotherapy for advanced disease, often based on the use of anthracyclines and taxanes, is quite difficult to achieve due to the development of dominant neoplastic cellular clones highly resistant to further therapy. Therefore the therapeutic index of second and third line chemotherapeutic treatments is usually quite low. Thirty patients with MBC with progressive disease after anthracycline-based chemotherapy as first line therapy were treated with l-FA 100 mg/m2/day and 5FU 1000 mg/m2/day ad continuous venous infusion for 96 hours every 4 weeks. Most patients (60%) had multiple sites of disease at entry and had visceral lesions as the dominant site of disease. Twenty-eight patients were evaluated for objective response: two patients had clinically progressive disease before restaging after the third cycle of chemotherapy. These patients were considered progressive disease since all patients were included in an intent-to-treat analysis. Nine patients achieved partial response for an overall response rate of 30% (intent-to-treat analysis) with a median duration of 9.5+ months (range 4.0/14.0 months), and disease stability was obtained in 10 cases (33%) with a median duration of 5.5 months (5-11). Progressive disease was recorded in 9 patients. After a median follow-up of 11 months, the overall median survival time of the whole series of patients was 14.0+ months. Objective responses were recorded both at visceral and bone sites. Chemotherapeutic treatment was generally quite well tolerated. No toxic deaths were recorded. Among gastrointestinal side-effects grade 3 stomatitis was noted in 30% of patients, and grade 3 diarrhea in 10% of cases. Grade 3-4 leukopenia was observed in 23% of patients, but significant episodes of febrile neutropenia were limited (2 patients). Grade 3 thrombocytopenia was seen only occasionally in 1 patient. Grade 1 anemia was recorded in 10% of patients. Hand-foot syndrome was noted in 2 patients (7%). Cardiotoxicity was minimal. The combination of 5FU and high-dose I-FA given as 96 hour continuous venous infusion was active, at least in terms of the overall response rate, against anthracycline refractory metastatic breast carcinoma. These results compare favourably with bolus 5FU/FA or other salvage regimens in terms of antineoplastic activity, and is well tolerated both subjectively and objectively by most patients.

Adult↗
PubMedDate not supplied

[Prognostic value of various classifications of acute delusional episodes].

A population of 56 cases of acute delusional disorders classified Bouffées délirantes by Pichot's diagnostic criteria is studied. Diagnostic methodology is described. Prognostic factors are assessed from individual variables, using a logistic linear regression model giving the probability of a favourable outcome. These prognostic factors are then adjusted considering gender.

Acute Disease↗
PubMedDate not supplied

Effect of flunisolide on nasal eosinophils and IgE, and symptom score in children with allergic rhinitis.

We evaluated the effect of treatment with flunisolide nasal spray (100 micrograms/day for 3 months) in 24 children with allergic rhinitis on the following parameters: clinical symptoms, absolute number of peripheral and nasal eosinophils, and total IgE levels in nasal secretion. Therapy with flunisolide induced a significant reduction of clinical symptoms (p < 0.001), nasal eosinophils (p < 0.001) and nasal IgE concentration (p < 0.02), while it did not affect the number of peripheral eosinophils. These results indicate that flunisolide can reduce the allergic inflammation of the nasal mucosa.

Administration, Intranasal↗
PubMedDate not supplied

[Exposure to low levels of solvents and noise, ear canal volume and audiometric pattern].

We described a case of a male worker, 62 years old, with a combined exposure to low noise levels (80-85 dB Leq,A) and organic solvents mixture for more than 30 years in the automobile industry as a painter. His ear canal has a diameter of more than 1.3 cm. and determine a peculiar pattern of hearing loss, similar to the noise induced one, but chiefly in the speech frequencies. According to experimental and human studies we speculate that in this patient the peculiar morphology of the audiogram, with the low or mean frequencies maximally affected, may been explained by a synergistic effect of solvents mixture in conjunction with noise exposure and a high ear canal volume.

Audiometry↗
PubMedDate not supplied

[Economic management of institutional pharmacies of the city of Rosario. Quality indicators proposal].

OBJECTIVE: To compare structures, procedures and results of the pharmaceutical management of institutional pharmacies in the city of Rosario (Argentina), to define the current situation and thus recommend changes. METHOD: Descriptive study, using a questionnaire and quality indicators of an Accreditation Program of Hospital Pharmacies. Evaluated dimensions: selection, acquisition, reception, storage and stock control of drugs and medical devices. Data was collected for a one-year-period in order to obtain indicators. After tabulation, data was discussed in meetings with all the pharmacists that participate in this study, in order to evaluate the situation and propose changes for the Pharmacies, as well as to evaluate the Program based on usefulness of these indicators. RESULTS: The general results illustrate how each institution has different health policies. 43.2% of indicators were answered, 67.6% reached standard values. CONCLUSIONS: This work allowed for an exhaustive analysis of the current situation. The pharmacists made proposals and unified criteria in order to obtain an improved use of the economic resources of each institution.

Argentina↗
PubMedDate not supplied

Surgical treatment of 100 single brain metastases. Analysis of the results.

The authors report their personal series of 100 consecutive surgically treated single brain metastases between 1981 and 1988. Patients selection was decided with respect to general and neurological conditions and to primary cancer development. Resection was mostly radical, postoperative mortality rate was 6% and neurological improvement was obtained in 73% of cases. Mean follow-up was 15 months (min. 12, max. 60). The overall median survival time was 13 months. The survival rate was studied with respect to age, lesion site, preoperative syndrome, primary cancer, cause of death and radiotherapy. On the base of their experience the Authors would stress that a better patients selection can further reduce the mortality rate.

Adult↗
PubMedDate not supplied

Intraventricular craniopharyngioma. Clinical and surgical considerations.

The authors present two cases of craniopharyngioma wholly located within the cavity of the third ventricle. The rarity of this condition is outlined. In these cases the computed tomography is not always sufficient to determine the correct surgical approach; therefore the Authors stress the importance of the clinical findings.

Adult↗
PubMedDate not supplied

"Primary" leptomeningeal dissemination of medulloblastoma. Report of an unusual case.

The Authors report the case of a 5-year-old boy medulloblastoma presenting with "primary" widespread diffusion in the subarachnoid spaces of the posterior fossa without true mass lesion. The diagnosis, suspected first on the basis of the computed tomography (CT) findings, was confirmed by cytological examination of the cerebrospinal fluid (CSF) and by surgery. The Authors analyse the peculiar clinical features (rapid and severe deterioration of general conditions, hyperacute course of the illness and fatal issue) and the morphological aspects of the tumor (CT and surgical findings). To our knowledge no case of "primary" dissemination of medulloblastoma was previously reported.

Brain Neoplasms↗
PubMedDate not supplied

The lung and primary immunodeficiency.

Primary immunodeficiences (ID), once considered to be very rare, are now increasingly recognized thanks to more knowledge in the immunological field and to the availability of more sophisticated diagnostic techniques. The respiratory tract and especially the lung are the most common targets of primary ID, and respiratory infections and/or failure are the most frequent causes of early death when the immune defect is not corrected with HLA-identical bone-marrow trans lant or, in few selected cases, with thymic extracts. Many patients with Ig deficiency are severely affected by chronic and recurrent respiratory infections, unfortunately leading to bronchiectasis in the majority of such patients. Today early i.v. gammaglobulin administration can prevent bronchiectasis, and this increases the chances of a better prognosis and of an improved quality of life as well.

Agammaglobulinemia↗
PubMedDate not supplied

IgA glomerulonephritis in Wiskott-Aldrich syndrome.

Renal morphology was evaluated in 2 siblings with Wiskott-Aldrich syndrome (WAS) aged 12 and 4 years. They gave a typical history of recurrent episodes of respiratory infection and presented with microhematuria of glomerular origin and proteinuria. The study disclosed a membranoproliferative glomerulonephritis with IgA mesangial deposition in the elder child, while immunofluorescence was negative in the younger. The data indicate that (1) a specific nephropathy does not exist in WAS and (2) the IgA nephropathy is the result of recurrent infections and of related formation of IgA immune complexes scarcely removed by a deficient reticuloendothelial system. This view is consistent with presenting features in WAS (microhematuria, episodes of macrohematuria, proteinuria, Henoch-Schönlein syndrome) and with the fact that it takes years to develop as indicated by the negativity of immunofluorescence in the younger patient.

Child↗
PubMedDate not supplied

[A rare cervico-facial teratoma in a newborn female infant].

The Authors report a case of a rare and very voluminous teratoma with uncommon location (the right cervico-facial region) and extracranial seat in a female newborn. The teratoma was excised in the 18th day of life. It showed cystic and solid lesions. The tissues were derived from the three germ layers and were prevalently mature; only a bit of them was represented by embryonic mesenchymal tissue. The baby, followed and checked up during all the first year of her life, showed a normal evolution and absence of recurrences.

Female↗
PubMedDate not supplied

[Controlled clinical trial of nomifensine in treatment of depression (author's transl)].

Therapeutic efficacy of Nomifensine and Nortriptyline was compared with a double blind study on 29 patients suffering from several kinds of depression. The patients were admitted to the Institute of Nervous and Mental Diseases of the University of Florence. Drugs were administered according to a flexible dosage varying from 50 mg to 125 mg/day, subdivided in 2-3 doses. The experiment is referred to the first 15 days of treatment. In order to estimate the effect of the drugs, the Hamilton's scale for depression was used. This scale was administered before treatment and on the 5th, 10th, 15th, day of therapy. Scores of Hamilton's scale and of some "Clusters" were computerized. It was found that Nomifensine has an antidepressant effect comparable to that of Nortriptyline. No relevant differences were noted in the range of action of these drugs. No side-effects were detected in the doses employed.

Adjustment Disorders↗