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Biomedical subjects

M Leoni

Publications and source records attributed to M Leoni.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Induction of bacterial translocation in rats with minimal doses of endotoxin].

OBJECTIVE: To determine whether a non lethal dose of intramuscular endotoxin in rats causes a physical disruption of the mucosal barrier and promotes the translocation of bacteria from gut to visceral organs. DESIGN: Prospective randomized trial. SETTING: Experimental laboratory university medical center. EXPERIMENTS: 60 male wistar rats, weighing 250 g. INTERVENTIONS: six hours and twenty-four hours after endotoxin (8 mg/kg) or saline (control group) given intramuscularly, rats were sacrificed and mesenteric lymph nodes, spleen and some segments of the ileum were removed. Lymph nodes and spleen were cultured for translocating bacteria while ileum segments were observed by light microscopy. RESULTS: Incidence of bacterial translocation increases from 6 hours (40% p < 0.05) to 24 hours (60%, p < 0.01) after endotoxin administration. Histologic evaluation of the ileum demonstrated that a mucosal injury occurred only at the 24 an hour and that it was characterized by an evident pronounced interstitial edema with focal breaks in the basal membranes of villous and glands. CONCLUSIONS: It appears that microorganisms and microbial products contained in the gut can cross the mucosal barrier and spread into other visceral organs also after a low dose of intramuscular endotoxin.

Animals↗
PubMed1991

Primary lymphoma of the central nervous system.

Primary lymphoma of the central nervous system (CNS) represents a pathology that is no longer considered rare, also in the light of its high correlation with the human immunodeficiency virus (HIV) syndrome reported recently. Often the correct diagnosis of the disease is difficult to reach, owing to the wide spectrum of non-lymphoma pathologies from which it should be differentiated and the invasiveness of some diagnostic techniques. The biologic aggressiveness of the neoplasm often makes a combined radio-chemotherapeutic approach necessary. In contrast, surgical resection does not seem to provide any significant benefit. The clinical experience reported here, together with a review of the most recent literature, lead the authors to suggest the opportunity of treating primary lymphoma of the CNS with the most active and modern chemotherapeutic protocols in association with traditional treatments to obtain an improvement in overall survival.

Aged↗
PubMed1991

Usefulness of fecal alpha 1-antitrypsin clearance and fecal concentration as early indicator of postoperative asymptomatic recurrence in Crohn's disease.

The aim of this study was to evaluate in Crohn's disease the possible usefulness of alpha 1-antitrypsin clearance and fecal concentration in the early detection of postoperative asymptomatic recurrence. Eleven adult patients with small bowel Crohn's disease undergoing elective resection were enrolled in the study and prospectively followed for one year. Three, six, and 12 months after surgery the alpha 1-antitrypsin clearance and fecal concentration were measured, and the disease activity was assessed. All patients were free of active symptoms throughout the study. One year after surgery small bowel radiology was performed in all patients. Radiographic evidence of recurrent macroscopic disease was found in five of the 11 patients. Three months after surgery both alpha 1-antitrypsin clearance and fecal concentration were significantly lower (P less than 0.01) than before surgery. There was no difference at this time between patients with recurrence and those with no recurrence. In patients with recurrence both alpha 1-antitrypsin clearance and fecal concentration significantly increased at six months in comparison with the values at three months (P less than 0.02). Both measurements were significantly higher at six and 12 months in this group of patients than in those with no recurrence and in normal controls (P less than 0.01). At six and 12 months alpha 1-antitrypsin clearance was above the upper normal limit in all patients with recurrence. We conclude that fecal alpha 1-antitrypsin clearance is a noninvasive, inexpensive, sensitive marker of asymptomatic recurrence in CD patients who are under regular supervision after surgery.

Adult↗
PubMed1991

Correlation of endometrial histology, morphometry, and ultrasound appearance after different stimulation protocols for in vitro fertilization.

The role of endometrial factors in controlling embryo implantation is poorly understood. In the present study, histopathology and morphometry were used to investigate differences in endometrial appearance seen by ultrasound (US) in 107 in vitro fertilization patients receiving different superovulation regimens. Seventy-seven patients received clomiphene citrate (CC)/human menopausal gonadotropin (hMG) and 30 buserelin acetate down regulation/hMG. All patients received an endometrial US at the time of embryo transfer (ET). Endometrial biopsies were taken from 17 women (12 CC/hMG, 5 buserelin acetate/hMG) with fertilization failure at the time when ET would normally have occurred. The morphometry results showed that endometrial glandular volume 2 days after oocyte retrieval was significantly reduced after CC/hMG compared with buserelin acetate/hMG, despite the fact that histopathological dating was similar for both groups. In addition, significant differences in endometrial thickness and echogenicity between CC/hMG and buserelin acetate/hMG were evident by US.

Adult↗
PubMed1990

Mitoxantrone (M) and vinblastine (V) in the treatment of advanced breast cancer.

Twenty-four patients with metastatic breast cancer, all but 1 pretreated with one or more chemotherapeutic regimens, were entered in a pilot study to assess toxicity and efficacy of the combination mitoxantrone and vinblastine. Dominant sites of metastases were viscera in 9 patients, bone in 10 and soft tissues in 5. All patients received mitoxantrone 10 mg/m2 i.v. on day 1 and vinblastine 1.7 mg/m2 by 4 hour infusion on days 3, 4 and 5, every 3-4 weeks. Objective responses (1 CR, 7 PR) were observed in 8 (38%) of the 21 evaluable patients. Median duration of response was 10.5 months. Of 12 patients pretreated with an anthracycline containing regimen, 4 responded (1 CR and 3 PR). Major toxicity was myelosuppression, grade 4 in 2 cases and grade 3 in 2 others. No evident alopecia was observed and only 1 case of grade 1 cardiac toxicity. In conclusion, mitoxantrone followed by vinblastine is an effective regimen in metastatic breast cancer also in pretreated patients, and previous anthracycline administration does not seem to reduce the percentage of response. Moreover, toxicity is generally mild.

Adult↗
PubMed1989

High-dose etoposide and autologous bone marrow transplantation as intensification treatment in small cell lung cancer: a pilot study.

A pilot study was conducted in which 15 patients with small cell lung cancer (SCLC) with limited or extended disease were treated with high dose etoposide (600 mg/m2 daily for 3 consecutive days) followed by autologous bone marrow transplantation (ABMT). Twelve patients underwent a double graft. All had achieved complete or partial remission with conventional induction chemotherapy (adriamycin and etoposide, plus cisplatin in five cases). After ABMT six of the 15 patients did not receive radiotherapy to the chest; all but four patients received prophylactic brain irradiation. No toxic deaths were recorded during the period of aplasia. Eleven patients relapsed and died after ABMT. The median time to death was 18 months. One other patient died at 13 months of unknown cause. At the present time three patients are alive and free of disease at 54, 51 and 47 months respectively. This pilot study shows that high dose etoposide and ABMT is well tolerated as late intensification for responsive SCLC. Definite conclusions about its precise role in therapy cannot yet be drawn.

Adult↗
PubMed1988

Postheparin plasma diamine oxidase in patients with small bowel Crohn's disease.

Diamine oxidase (DAO) is an enzyme located almost exclusively in villus tip enterocytes of mammals. Its plasma activity, normally very low, is enhanced by intravenous heparin, which releases the enyzme from small bowel enterocytes into the blood. Plasma postheparin DAO (PHD) values have been shown to be significantly reduced in patients with malabsorption and villous atrophy and inversely correlated with 24-h fecal fat, thus suggesting that PHD reflects the mature enterocytic mass. We have assayed PHD in 51 patients with small bowel Crohn's disease by measuring the area under the plasma DAO curve over a 120-min period after an intravenous bolus of 15,000 IU of heparin. Postheparin plasma DAO was significantly lower (p less than 0.001) in patients (328 +/- 175 U/ml.min) than in 20 normal subjects (508 +/- 101 U/ml.min; range, 391-749). Postheparin diamine oxidase values were inversely correlated with Crohn's disease activity index (CDAI), but no correlation was found with extent of disease assessed radiologically by either double-contrast small bowel enema or barium meal follow-through. In 6 patients with active disease (CDAI, 297 +/- 99) and low PHD values (188 +/- 100 U/ml.min), the assay was repeated after a clinically effective course of antiinflammatory drugs. A significant increase in PHD values (388 +/- 112 U/ml.min) was observed (p less than 0.005). These data indicate that mucosal involvement is common in small bowel Crohn's disease and that PHD may be useful in assessing and monitoring mucosal damage in these patients.

Adult↗
PubMed1988

The clinical significance of serum C reactive protein levels in Crohn's disease. Results of a prospective longitudinal study.

We measured the serum C reactive protein (CRP) levels by a sensitive immunochemistry method in 101 outpatients with Crohn's disease enrolled in a prospective longitudinal study. At entry, 51 of the 101 patients had raised CRP levels, which showed good correlation with the clinical score. However, one-third of the patients with clinically active disease had normal CRP while one-third of the patients in clinical remission had a raised CRP. The longitudinal study showed that (a) in patients with active disease, CRP levels tended to decrease as the disease went into remission; (b) in patients who achieved remission, the likelihood of clinical relapse after 2 years of entry was higher in those with persistently raised CRP than in those with persistently normal CRP; and (c) in patients with quiescent disease at entry who remained in remission throughout the first year of the study, the likelihood of clinical relapse during the second year of the study was higher for those with persistently raised CRP than for the others. This study confirms that serum CRP is a useful laboratory index for supplementing clinical scores in patients with Crohn's disease, in monitoring the response to treatment, in helping to predict the course of the disease, and in contributing to defining subgroups of patients.

C-Reactive Protein↗
PubMed1988

A randomized clinical trial comparing radiation therapy v radiation therapy plus cis-dichlorodiammine platinum (II) in the treatment of locally advanced non-small cell lung cancer.

Cis-Dichlorodiammine platinum (II) (cis-DDP) was demonstrated to be a potentiator of radiation therapy (RT) in experimental tumor models and in cultured cells. To assess the effectiveness of a combined modality treatment including RT and a weekly low-dose administration of cis-DDP, from January 1986 to June 1987, 95 patients with unresectable locally advanced non-small cell carcinoma of the lung (stage IIIa, b) were randomized for study. Fifty patients received RT alone at doses of 50 Gy; 45 patients received the same RT plus cis-DDP 15 mg/m2 IV weekly. An overall response rate of 50% and 64% was observed in the RT and RT + cis-DDP group, respectively. No statistically significant differences were detected with regard to median survival time (11 months for RT v 16 months for RT + cis-DDP) and progression-free interval (7 months in the RT arm v 9 months in the RT + cis-DDP arm), but the patterns of the first failure appeared to be affected by treatment. In fact, a lower number of intrathoracic relapses was observed in the RT + cis-DDP arm (12 in the RT + cis-DDP v 23 in the RT arm). Toxicity was mild and the feasibility of this schedule must be remarked. A better local control of disease can be obtained using cis-DDP as a radiation potentiator, but the true influence of this combined modality treatment on the length of survival, and the optimal cis-DDP timing and dosage are still to be evaluated in further clinical trials.

Carcinoma, Non-Small-Cell Lung↗
PubMed1987

Cis-platin and radiotherapy in the treatment of unresectable lung cancer.

The goal of this pilot study was to verify the efficacy of the association of cisplatin plus radiotherapy in the treatment of lung cancer. Thirty-seven consecutive patients entered the study. They were treated with radiotherapy (four weekly doses of 2.5 Gy for a total of 50 Gy) and cis-platin once weekly (12 mg/m2). Partial remission was obtained in 15 patients, and 1 patient had a complete remission. Three patients previously inoperable underwent surgical treatment. The actuarial survival curve of the 29 evaluable patients showed a mean survival of 8.5 months. The mean survival of the latter is not evaluable because half of the patients are still alive after 12 to 30 months. No hematologic or renal toxicity was observed with the above schedule.

Adult↗
PubMed1987

Radiotherapy versus radiotherapy plus cisplatin treatment for locally advanced non small cell lung cancer: preliminary results of a randomized study.

Preliminary results of a randomized study (radiotherapy versus radiotherapy plus weekly low-dose cisplatin) are reported. Fifty-four patients (43 evaluable) with stage IIIa-b non small cell lung cancer were randomized. Objective responses (CR + PR) were seen in 62% of the radiotherapy-treated group and in 63% of the group treated with radiotherapy plus cisplatin. No major toxicity was seen. Patient compliance for both treatments was satisfactory.

Adult↗
PubMedDate not supplied

The use of granulocyte colony-stimulating factors following peripheral blood progenitor cell rescue after high-dose chemotherapy for advanced breast cancer: a prospective study.

The use of high-dose chemotherapy followed by hematopoietic rescue is increasing worldwide for solid tumors. Several studies have suggested that the period of absolute neutrophil count (ANC, < 500/ml) may be shortened in patients who receive peripheral blood progenitor cells (PBPC). To estimate the clinical value of granulocyte-colony-stimulating factor, we examined a cohort of 26 consecutive patients with advanced breast cancer who received one or two cycles of high-dose chemotherapy with PBPC rescue with or without filgrastim. Thirty-five courses of high-dose ICE (ifosfamide, carboplatin, etoposide) chemotherapy were administered and evaluated. All patients received PBPC rescue. Sixteen patients (21 courses) received subcutaneous filgrastim (5 mg/kg) following PBPC infusion. Recovery to > or = 500 ANC occurred at a median time of 7 days post PBPC infusion among patients who received filgrastim versus 10 days among patients who received standard support care only (P < 0.01). The administration of filgrastim was not associated with a reduction in the duration of hospitalization, in the total number of days on nonprophylactic antibiotics, number of red blood cell transfusions, time to platelet engraftment, or number of febrile days. This could be the consequence of the high hematopoietic cell dose administered in the study. Therefore, any effect of filgrastim was probably masked by the use of a large number of PBPC. Larger prospective randomized studies, specifically focused on the utility of the administration of growth factors following high-dose chemotherapy and PBPC rescue, may be warranted to know whether the administration of filgrastim after PBPC transplantation is really necessary.

Adult↗
PubMedDate not supplied

The role of radiotherapy in the treatment of carcinoma of the prostate: a survey of clinical practices in Lombardy, Italy, by the AIRO-Lombardia Cooperative Group. Italian Association for Radiation Oncology.

AIMS AND BACKGROUND: We report the results of a survey performed in 1994 by the AIRO-Lombardia Cooperative Group, on the clinical patterns of radiation treatment for prostatic carcinoma in Lombardy, Italy, involving all radiotherapy centers serving an overall local population of about 8,800,000 people. METHODS: A questionnaire was sent to all 13 radiotherapy centers throughout Lombardy, asking for demographic and treatment details concerning the local population of patients with a localized (T1-4, N0-1, M0) carcinoma of the prostate treated with radiotherapy; 12 centers responded, making the basis for the present report. RESULTS: Analysis of collected data showed that in Lombardy: a) approximately 400 patients per year are irradiated for a localized carcinoma of the prostate, accounting for less than 30% of the total expected number of patients with this disease presentation; b) a complete staging (with PSA, transrectal ultrasonography, abdomino-pelvic CT or MRI scan and total-body bone scan) is performed in over 95% of patients before initiating radiotherapy; c) significant differences exist between radiotherapy centers as regards treatment planning and delivery. CONCLUSIONS: An urgent need exists for implementing procedures aimed at standardizing radiotherapy procedures within Lombardy.

Carcinoma↗
PubMedDate not supplied

Minimal requirements in prostate cancer irradiation: a consensus document by the AIRO Lombardia Cooperative Group.

PURPOSE: With the aim of establishing clinical and technical criteria to homogenize radiotherapy practice, a working group of AIRO-Lombardia (Associazione Italiana di Radioterapia Oncologica--Gruppo regionale della Lombardia) has tried to define minimal requirements for radical and postoperative irradiation in prostate cancer. The document has been structured in such a way as to be also of interest to the urological and medical oncology communities. METHODS: The working group, composed of representatives of most of the regional radiotherapy departments in the Lombardy region, had monthly meetings during 1996 and 1997. The document on minimal requirements has been derived from the participants' combined experience and knowledge, from review of the literature, and from a 1995 regional survey on current practice of prostate irradiation. RESULTS: Minimal requirements for radical and postoperative irradiation of prostate cancer have been defined with respect to treatment strategies, pre-treatment diagnostic evaluation and staging, treatment prescription, preparation and execution, and quality assurance procedures. CONCLUSION: Standards of reference for minimal requirements in prostate cancer irradiation adapted to the regional structures and resources have been defined.

Humans↗