Biomedical subjects

Massimo Maffezzini

Publications and source records attributed to Massimo Maffezzini.

22 records · Page 2Linked to original sources

PubMed2002

Bladder cancer.

Bladder cancer is the second most frequent tumour of the urogenital tract. Tobacco smoke has been shown to increase the risk of bladder cancer two- to fivefold as well as the exposure to metabolites of aniline dyes and other aromatic amines. Seventy-five per cent of bladder cancers are superficial at initial presentation, limited to the mucosa, submucosa, or lamina propria. Recurrence rates after initial treatment are 50-80%, with progression to muscle-invading tumour in 10-25%. In muscle-invading bladder cancers, there is a 50% risk of distant metastases. Surgery is the mainstay of standard treatment both in the form of transurethral endoscopic resection, mainly for superficial disease, and in the form of open ablative surgery with urinary diversion for muscle invasive disease. Endovesical administration of BCG has been employed after endoscopic resection as the most effective agent for both prophylaxis of disease recurrence and progression from superficial to invasive disease. The accepted treatment for muscle infiltrative disease is radical cystectomy. Response rates to combination chemotherapy regimens of up to 70% in patients with advanced metastatic disease have led to an investigation of its use for locally invasive disease in combination with conventional modalities of treatment.

Antineoplastic Agents↗

PubMed2002

A single injection of lidocaine as local anesthesia for ultrasound guided needle biopsy of the prostate.

PURPOSE: We evaluated the effectiveness of a single injection of lidocaine on patient tolerance of multiple needle biopsies of the prostate. MATERIALS AND METHODS: In 100 consecutive group 1 patients local anesthesia was achieved by a single bolus injection of 10 ml. lidocaine and multiple prostatic needle biopsies was performed under ultrasound guidance. At the end of the procedure patients were asked to complete a questionnaire regarding the level of pain. Answers were compared with those of 100 group 2 patients who underwent prostatic biopsy before the introduction of local anesthesia. RESULTS: Of the group 1 patients 93% had only slight discomfort during the procedure and 7% required a further 1 cc bolus of lidocaine. In 55% of group 2 patients the level of pain during the procedure was significant but bearable, in 35% it was considered unbearable and in 10% sedation with midazolam was necessary. There was no significant difference in complications in the 2 groups. CONCLUSIONS: A single injection of local anesthesia for prostatic biopsy proved to be efficient, well tolerated by patients and effective for decreasing the pain associated with the procedure.

Anesthetics, Local↗

PubMed2002

[Nephron-sparing surgery. Reproducibility of results, personal cases, and comparison with the international literature].

PURPOSE: Partial nephrectomy is an effective method of treatment for renal cell carcinoma. The aim of this study is to compare our experience with international literature data METHODS: Between January 1997 and December 2000 a total of 50 renal units in 30 males and 18 women, 27 to 77 years old (mean age 60.6) with renal solid lesion of < 4 cm diameter were treated at our institution with nephron sparing surgery (NSS). The indications for NSS was elective in 43 case, imperative in 5. So far no local metastases, or vascular involvement have been encountered. The procedure was performed by 4 surgeons alternatively. RESULTS: In 25 patients histology revealed with clear renal cell carcinoma, one case of the chromophobe cell type, 6 papillary renal cell carcinoma, 8 oncocytomas, 8 angiomyolipomas, 1 multicystic and 1 simple cyst renal carcinoma. The complications were 1 acute reversible renal failure and 1 arteriovenous fistula. At the follow-up of 23 months no local or distant metastases were encountered. No significant differences in results were noted in regard to surgeon. CONCLUSIONS: Our results suggest that nephron sparing surgery is as effective as radical nephrectomy for treatment of localised RCC. The reduced incidence of complications associated with a minimum complexity of the procedure and the results make this technique approachable by surgeons of different technical experience.

Adenocarcinoma↗

PubMedDate not supplied

Intravesical gemcitabine in recurrent superficial bladder carcinoma: preliminary results on ablative efficacy and tolerability.

BACKGROUND: The ablative potential and toxicity of gemcitabine, administered intravesically in low stage and grade superficial transitional cell carcinoma (TCC), were evaluated. PATIENTS AND METHODS: Patients with a history of recurrent Ta-T1, GI-G2 bladder TCC were considered eligible for the study. Gemcitabine was administered intravesically at 40 mg/mL concentration (2000 mg in 50 ml saline) in one weekly instillation for 4 consecutive weeks. Fifteen days after the last instillation, patients were submitted to transurethral resection (TUR). RESULTS: Twenty-six patients were evaluable for toxicity, and 20 were evaluable for response, 6 patients being excluded due to toxicity. A complete response was achieved by 10 out of 20 patients (50%), whereas no response was documented in the remainder. Toxicity leading to treatment interruption was grade 3 in 1 patient and grade 2 in 5 patients. CONCLUSION: Intravesical gemcitabine administered at 40 mg/mL showed the capability of ablating small volume, superficial TCC in 50% of the population under study, with acceptable tolerability.

Administration, Intravesical↗