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Biomedical subjects

M Giovannini

Publications and source records attributed to M Giovannini.

389 records · Page 22Linked to original sources
PubMedDate not supplied

[Effect of medroxyprogesterone acetate (MAP) in high doses on chlorambucil-induced bone marrow depression. Preliminary results].

On the basis of previous observations indicating that Medroxyprogesterone Acetate (MAP) administered in high doses induces leukocytosis and an increase in the platelet count, the Authors have studied the effect of high-dose MAP on leukocytes and platelets when it was combined with Chlorambucil (CLB) in patients suffering from ovarian cancer in various stages. 28 patients treated with high-dose MAP and CLB showed a statistically significant lower mean reduction of WBC count and reduction of the incidence, entity, and duration of the leukopenia as compared to 29 patients treated only with CLB. These effects were particularly evident when MAP was administered intramuscularly. It was not possible to evaluate the effect of high-dose MAP on the platelet count because the CLB regimen did not induce a significant decrease in it. These preliminary results are interesting because they suggest the possibility that high-dose MAP, which has already been utilized in oncology for its antitumor, analgesic, and anabolic activity in the treatment of breast, endometrial, renal, and prostatic cancer, might be able to be employed to reduce the myelotoxic effects of chemotherapy.

Administration, Oral↗
PubMedDate not supplied

[Use of a new amino acid mixture in the diet therapy of patients with classical phenylketonuria].

The treatment of classic PKU is based on the dietary restriction of phenylalanine. The present study was planned to evaluate the effectiveness of a new amino acid mixture (ASP-Nestlé) in the dietary treatment of ten PKU patients (age 2 to 9 years, mean 5 years). The children were given this product for a minimum of 3 and a maximum of 12 months (mean 8 months). The aminoacid mixture, diluted in water or various flavored drinks, was favorably accepted by the patients. No clinical signs of hypophenylalaninemia were noticed and the children grew regularly in height and weight. The biochemical parameters, evaluated before during and after the treatment, showed a good nutritional balance. The plasma phenylalanine control was excellent, when compared to the plasma phenylalanine range obtained with other dietary regimens.

Amino Acids↗
PubMedDate not supplied

Staging of rectal cancer: a prospective study of digital examination and endosonography before and after preoperative radiotherapy.

Between January 1988 and January 1992, 34 patients with rectal cancer were evaluated both by clinical examination and endosonography before and after pre-operative radiotherapy. Two criteria were correlated with histologic findings: confinement to the rectal wall or spread beyond, the presence of mesorectal lymph node involvement. The 32 patients who underwent endosonography before radiotherapy were staged as: uT2: 4, uT3: 26, uT4: 2 cases. Fifteen days after irradiation, endosonography showed tumour regression in all cases; uT stage was different in 15 patients, uN stage in 4 cases. Comparison of the pre-operative local invasion beyond the rectal wall with postoperative histopathy revealed a correlation with: digital examination after radiotherapy in 20 of the 31 patients with palpable tumours; endosonography before irradiation in 18 of the 32 staged tumours; endosonography after irradiation in 25 of the 32 staged tumours. The presence of mesorectal lymph node involvement determined by histologic examination was correlated with the results of endosonography after radiotherapy for 22 of the 32 staged tumours. Endosonography provides a good assessment of the tumour stage before irradiation. Since radiotherapy alters endosonographic staging of rectal cancer, this staging should be included in survival studies.

Adenocarcinoma↗
PubMedDate not supplied

Recent advances in systemic chemotherapy of metastatic colorectal cancer.

Colorectal cancer is the second most common cancer in the Western world. Nearly 6 out of 10 patients with colorectal cancer have or will have metastasis, and among patients with advanced disease, the liver is the most common site involved (in up to 70% of patients). Chemotherapy of advanced CRC was long considered as ineffective. Recently, however, chemotherapy has made great strides: a number of successful regimens have been reported especially since 1990. The first randomized trials showing a significant extension of survival in patients treated by chemotherapy as compared to those receiving only supportive care were published in 1992 and 1993. This article provides an up-to-date overview of palliative chemotherapy for metastatic colorectal cancer: tumor reduction is two times greater when 5FU is administered in combination with folinic acid or with Methotrexate than when it is administered alone. According to some studies, these combinations may also significantly improve the duration and quality of survival. Two recent controlled studies comparing systemic chemotherapy with supportive care showed a significant improvement in the duration of survival and a study in asymptomatic patients indicated a significant extension of the duration of the symptom-free period. Hepatic intra-arterial chemotherapy significantly prolongs survival but toxicity is high. Further clinical testing is needed to evaluate new agents, improve tolerance to treatment, and evaluate chemotherapy as a bridge to surgery for patients with initially inoperable metastasis.

Antineoplastic Agents↗
PubMedDate not supplied

[Management of ventricular arrhythmia in chronic congestive heart failure].

PURPOSE: To evaluate efficacy and indications of therapy for ventricular arrhythmias in patients with chronic congestive heart failure. DESIGN: A review of most significant and recent clinical trials was performed. RESULTS: In patients with severe left ventricular dysfunction, the desirable actions of antiarrhythmic drugs are attenuated and their negative inotropic and proarrhythmic actions are enhanced. Treatment should be limited to patients with malignant ventricular arrhythmias, or to patients considered at high risk. When indicated, amiodarone is usually well tolerated and safe. The prevention of sudden death in patients with heart failure should be based on optimized therapy of pump failure, reducing left ventricle work load and modulating neurohormonal systems with ACE-inhibitors and betablockers drugs. Further, an important role is held by anti-ischemic therapy, revascularization procedures, anticoagulant therapy and prevention of electrolytes unbalances. Patients with sustained of high risk arrhythmias, resuscitated from a cardiac arrest, should be considered for transvenous Implantable Cardioverter Defibrillator (ICD) implant. CONCLUSIONS: Ventricular arrhythmias are common in heart failure patients, represent an important cause of sudden death and the choice of treatment is difficult because of the complexity of underlying mechanisms, frequency of adverse reactions and the severity of left ventricular dysfunction.

Anti-Arrhythmia Agents↗