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Biomedical subjects

M Greco

Publications and source records attributed to M Greco.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Activity and toxicity of 4'-iodo-4'-deoxydoxorubicin in patients with advanced breast cancer.

Based on our previous Phase I study indicating good tolerability of the drug, we have evaluated therapeutic activity and acute and subacute toxicities associated with repeated courses of the new anthracycline 4'-iodo-4'-deoxydoxorubicin (I-Dox) at the maximum tolerated dose (80 mg/m2) every three weeks. Thirty-three patients (31 evaluated for activity and 32 for toxicity) with relapsed (11 cases) or advanced breast cancer at presentation (22 cases) were treated with 108 cycles (median 3, range 1-7) for a median cumulative dose of 240 mg/m2. We observed no complete and 11 (35%) partial responses. Minor response was documented in 5 additional patients. The most frequent and severe toxicity was hematological. In 47% of the cycles and 34% of the patients I-Dox administration was associated with WHO grade 4 neutropenia. Severe neutropenia was more frequent after repeated cycles. Similar cumulative toxicity was observed for thrombocytopenia and anemia. In three patients (7 cycles) fever and possible infection occurred during neutropenia and required oral antibiotics. Extra-hematological side-effects were limited to mild/moderate nausea lasting for a few hours and mild fatigue lasting 1-7 days. Alopecia or oral mucositis were minimal or absent in the majority of patients. One case of potential reversible cardiac toxicity was observed after 240 mg/m2 I-Dox in a patient with preexistent cardiac risk factors. In view of the reported activity, good general tolerability, and selective hematological toxicity, I-Dox should be evaluated at higher than the conventionally defined maximum tolerated dose in combination with recombinant human hemopoietic growth factors.

Adult↗
PubMedDate not supplied

Nuclear medicine advances in breast cancer imaging.

Primary breast cancer imaging can be done by various means. Mammography is the most widely used technique because of its excellent diagnostic performance, patient compliance, and cost-effectiveness ratio. Other radiological techniques (such as ultrasonography) are indicated in particular circumstances, while some (such as digital mammography and magnetic resonance imaging) seem very promising but are still under evaluation. The recent technological progress in nuclear medicine has resulted in the availability of two diagnostic procedures that have been validated by extensive international clinical experience: scintimammography with Sesta-MIBI and positron emission tomography (PET) with fluorodeoxyglucose (FDG). The general advantage of nuclear medicine imaging is that tumor-seeking radiopharmaceuticals accumulate in cancer lesions, which makes scintimammography and PET fundamentally different from the radiological techniques that image the tumor mainly on the basis of morphological alterations. Scintimammography is indicated for the study of breast lesions in patients in whom mammography is non-diagnostic or difficult to interpret; it may be useful also to assess and even predict the response to primary chemotherapy. FDG-PET is increasingly used in oncology and is particularly useful in breast cancer as it gives more accurate information than scintimammography in the evaluation of patients with ambiguous mammographies and in discriminating between viable tumor, fibrotic scar or necrosis following surgery, chemo- or radiotherapy. The FDG uptake in the tumor correlates with the histological grade and potential aggressiveness of breast cancer, which may have prognostic implications. In addition to its usefulness in the study of breast lesions, FDG-PET shows great efficacy in detecting lymph node involvement prior to surgery. Whole-body PET provides information on soft tissue and bone metastases in a single scanning session, and has an important clinical role in detecting recurrent metastatic disease. On the basis of the above-mentioned evidence, nuclear medicine techniques, integrated with radiological techniques, offer an interesting opportunity to improve the diagnostic imaging yield in breast cancer, which will eventually lead to better patient management. This paper reports on the latest developments in this field.

Breast Neoplasms↗
PubMedDate not supplied

Serum phosphoexose isomerase in cancer.

Serum levels of phosphoexose isomerase (PHI) were determined in 138 cancer patients. The enzyme levels showed a relation to the clinical stage of the tumor, and were, on the average, higher in advanced disease. The behavior of the enzyme levels after chemotherapy and/or radiotherapy was studied in relation to the clinical response. A statistically significant reduction of PHI activity in patients with subjective and objective or only subjective responses to therapy was noted. The mean values before and after chemotherapy in patients with progression of the disease were not significantly different. The authors conclude that high levels of serum PHI are, most often, associated with an advanced and/or a metastasized tumor; furthermore PHI seems to be a reliable biologic marker of the destruction of cancer tissue.

Female↗
PubMedDate not supplied

Sexually transmitted diseases in homosexual and bisexual males from a cohort of human immunodeficiency virus negative volunteers (Project Horizonte), Belo Horizonte, Brazil.

Sexually transmitted diseases (STD) are very frequent in the whole world. Males who do not use a condom during their sexual relations are at great risk. We report cases of STD during six months of observation, among homosexual/bisexual males who participate in the Project Horizonte. There were 16 cases of genital warts, 6 cases of human immunodeficiency virus infection, 24 cases of unspecific urethritis, 28 cases of herpes simplex virus infection, 30 cases of syphilis, 58 cases of gonorrhea and 84 cases of pediculosis. We concluded that a condom must be used in all sexual relations and new counseling techniques are needed, to avoid this situation.

Adolescent↗
PubMedDate not supplied

S100 protein serum levels in cutaneous malignant melanoma.

We investigated the utility of serum S100 determined by means of immunoradiometric assay in a cohort of 438 patients affected by cutaneous melanoma (126 untreated and 312 previously treated). Using 0.2 microg/l cut-off value, determined in 134 healthy blood donors, the sensitivity was 4.2% in stage I patients (4/94), 5.3% in stage II patients (1/19), and 38.5% in stage III patients (5/13). Even though the sensitivity increased progressively from stage I to stage II and III, these differences were not statistically significant. The prognostic significance of S100 evaluation at diagnosis was investigated in terms of survival but no statistical correlation between S100 basal levels and survival was found. In the 312 previously treated patients serum S100 levels were correlated to disease extent, high levels of the marker were observed in 42.8% (9/21) of patients with local recurrence, in 32% (16/50) of patients with lymph node and/or in-transit metastases, in 77.3% (17/22) of patients with distant metastases, and in patients with NED, the specificity of the marker was 96.8% (212/219). The difference between these groups were statistically significant. In conclusion, S100 protein was abnormally high in patients with metastatic malignant melanoma. Serial S100 measurements in a follow-up study are necessary to test the importance of the protein in the management of patients with metastatic malignant melanoma.

Adolescent↗
PubMedDate not supplied

[Bilateral sclerosing lipogranuloma of the gluteal region with calcification. Report of a clinical case and review of the literature].

A rare case of large bilateral sclerosing lipogranuloma with multiple calcifications of gluteal region is described in an old female patient affected by a cerebrovascular disease. The lesions appeared as firm, nontender, plaques, 9-10 cm in diameter, covered with hyperpigmented skin. This uncommon disorder is discussed on the basis of data obtained from an extensive literature review. The term "sclerosing lipogranuloma" was coined in 1950, and it defines a disease of the subcutaneous fat, which for a trauma or unknown reasons undergoes necrosis of fat cells with the release of fat droplets into intercellular spaces and a peculiar local sclerosing granulomatous reaction of fatty tissue. The cytosteatonecrosis and sclerosing lipogranuloma, post-traumatic or secondary to injection of exogenous oily substances, usually localized in the breast of women and in genitalia of men, are relatively well known. Sclerosing lipogranulomatosis of the orbita and eyelides, an infrequent but severe complication after endonasal surgery, has also been reported. Rarely, the lipogranuloma can be spontaneous or idiopathic or primitive. A particular form of genetic diffuse lipogranulomatosis is the Farber's syndrome, firstly described on 1947. In our patient, the absence of trauma seems to indicate a primitive lipogranuloma. The presence of an acute rheumatic syndrome responsive to corticosteroids, and the positivity of antimitochondrial autoantibodies are in accordance with the report of sclerosing multiple lipogranulomatosis associated with a lupus-like syndrome. Because of the long duration and the absence of acute local symptoms, this syndrome can be considered benign with favorable prognosis, but the physician should know it.

Aged↗
PubMedDate not supplied

[Separations and divorces in Italy according to the age of the spouses and the duration of marriage (1969-1978)].

"An analysis of judicial separations (1969-1978) and divorces (1971-1978) in Italy is presented...with reference to the duration of marriage and the age of husband and wife, using...data collected by ISTAT (Italian Central Statistical Institute)." It is found that the risk of separation or divorce is greater for shorter marriage durations (3-6 years), for individuals who marry at younger ages, and for marriages performed during World War II. (summary in ENG, FRE)

Age Factors↗
PubMedDate not supplied

[The ultrasonographic examination in hematuria. Evaluation of its diagnostic possibilities].

Hematuria is a very frequent clinical occurrence and is connected with a number of genito-urinary diseases. Our present work is aimed at checking the usefulness of ultrasonography (US) in etiological diagnostic of hematuria. 516 patients with hematuria and 1788 controls were included in the present study. Renal and urological diseases were found in 74% of patients with hematuria and in 22.7% of those without. Their prevalence is analogous of the general population for those diseases easily detectable by US, such as cystic and heteroplastic diseases. On the contrary, no correspondence was observed for cases of inflammatory, for which echography has never been a reliable diagnostic tool. Furthermore, US sensitivity, if associated with hematuria, was 93%, specificity was 100%, diagnostic accuracy 99% and predictive value about 100%. Ultrasonography is easy to perform, well tolerated, involves low cost and may therefore be considered as the investigation technique of choice for the study of hematuria.

Adult↗
PubMedDate not supplied

Abdominal radiography findings in small bowel anastomoses with V-BAR.

PURPOSE: The aim of the present paper is to describe the normal radiological findings and the fragmentation time of the VALTRAC BAR (V-BAR). MATERIALS AND METHODS: Ten cases of Roux-en-Y jejuno-jejunostomy with anastomosis with a n.25 Valtrac ring for gastric cancer were followed up during the postoperative period by plain abdominal X-ray examination. RESULTS: Abdominal X-ray examination showed V-BAR fragmentation between day 14 and 21 after surgery. In one case only did fragmentation fail and the V-BAR migrated resulting in mechanical ileus. CONCLUSIONS: The possible non-fragmentation and migration of the V-BAR confirms the need to follow up patients with plain abdominal radiography performed at short intervals during the postoperative period.

Journal Article↗
PubMedDate not supplied

[Caloric intake and distribution of the main nutrients in a population of obese children].

Calorie intake and the main nutrient contents were assessed in a population of 152 obese (OB) children (86 M; 66 F; age 7-11) and 153 normal weight (NW) peers (87 M; 66 F). The following method was used: a) an interview using a food dictionary to assess food intake during the 2 days prior to the study and on one holiday: and b) a weekly questionnaire. The mean food intake of OB did not exceed that of NW, but on the contrary was lower (OB: 1812.9 +/- 39.6 kcal/die; NW: 1928.5 +/- 39.4 kcal/die; p less than 0.05). The population studied consumed approximately 50% of calories as carbohydrates (CHO), 35% as fats (F) and 15% as protein (P), and no difference was noted between OB and NW. The percentage of CHO was lower than that recommended by LARN, whereas the percentages of F and P were higher. A significant increase with age was noted in F and P intake as was a significant reduction of CO. 70% of OB and 80% of NW matched or exceeded the calorie intake recommended by LARN. 30% of OB and 24% of NW consumed 30% less than the daily calorie intake recommended by LARN.

Child↗
PubMedDate not supplied

[Evaluation of the microbial burden using rinsing of the oral cavity in patients undergoing bone marrow transplantation].

We report the methodology and the results of our research on the total microbic charge of the oral cavity carried out in 35 (thirty-five) patients undergoing bone marrow transplant and selective decontamination at the Bone Marrow Transplant Unit Perugia, between July 1985 and December 1988. The specimens, obtained by washing the oral cavity for 15 seconds with 10 ml of sterile distilled water, were taken from each patient during his stay in the Laminar Air Flow Room (from day -7 to day +28 of the transplant). The first sample was taken before starting the selective decontamination and the microbiological controls were carried out weekly. The quantitative determination of the microbic charge was made by diluting and plating, while selective media for gram-positive and gram-negative microorganisms were used for the qualitative evaluation. The results obtained prove the effectiveness of the mouth-wash method as an instrument for the evaluation of microbial contamination of the "mouth"-area, since it determines the oral microbic flora by standardized counting and testing methods which are simple to use and give rapid and reliable results. Furthermore, this method has proved to be especially useful for studying the effectiveness of the decontamination and chemoprophylaxis treatments carried out on the patients undergoing bone marrow transplants.

Anti-Bacterial Agents↗