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P Pisani

Publications and source records attributed to P Pisani.

At least 91 records · Page 5Linked to original sources
PubMed1988

[Radiotherapy in the treatment of carcinomas of the base of the tongue. Analysis of the literature and personal experience].

Carcinoma of the base of the tongue is usually treated with radiation therapy. After a review of the literature, the findings are reported of 129 patients with squamous cell carcinoma of the base of the tongue treated in 1979-1983, with a minimum of a 3-year follow-up: 8 T1, 40 T2, 60 T3 and 21 T4 were found; only 48 cases were N0. Advanced stages (stage III and stage IV) were 83% of the total. External photon irradiation (Cobalt-60) was used in all cases; 33 patients underwent chemotherapy or surgery as additional treatment. The overall local control rate was 45.7%. Local control decreased as T stage advanced: T1 62.5%, T2 55%, T3 41.7% and T4 33.3%. The overall regional control rate for lymph nodes clinically palpable was 51.8%. The overall actuarial 5-year survival rate was 29.1%. The 5-year survival rate according to the N-staging varied from 37% for N0-stage to 17.4% for N3-stage. The majority of failures (92.8%) occurred within 2 years since the end of the therapy. Treatment complications, secondary carcinomas and causes of death are also discussed. Radiation therapy has proven to be effective for early-stage carcinoma of the base of the tongue; in more extensive lesions results are poor. Improved results could be obtained by optimal application of radiotherapeutic techniques. Knowledge of the various prognostic factors is essential to administer the therapeutic regimen for a given patient by the characteristics of his particular tumor.

Adult↗
PubMed1988

The occurrence of cholangitis after percutaneous biliary drainage: evaluation of some risk factors.

Sepsis of the biliary tract is often reported after percutaneous transhepatic biliary drainage (PTBD) and is considered a life-threatening condition. The authors studied 39 patients with biliary stenosis (35 with neoplastic stricture and four with benign disease) with the purpose of identifying some factors possibly associated with a higher risk of cholangitis. None of the patients complained of biliary sepsis at the first clinical examination. Several factors were taken into account and were statistically tested according to Miettinen rate ratios to differentiate patients in whom cholangitis would consequently develop: nature, site and extent of basic disease, type and functioning of PTBD, skin contamination at puncture site of PTBD, and bile contamination at PTBD and at follow-up. The presence of bacteria in the first bile (31.5%) was not related to a higher risk. All subjects showed bile contamination after PTBD, but cholangitis developed in only 15 patients, and it was always supported by enteric microorganisms. When we compared patients with cholangitis and subjects without infection, it was possible to demonstrate a statistically significant association of cholangitis and the following: nature of the stricture, presence of multiple intrahepatic biliary obstruction, neoplastic invasion or compression on the duodenum, and presence of Staphylococcus aureus on the skin at puncture site at drainage.

Adult↗
PubMed1987

Vitamin A and female lung cancer: a case-control study on plasma and diet.

Plasma and dietary levels of retinol and beta-carotene were evaluated in a consecutive series of 47 females with histologically proven primary lung cancer and 159 nonneoplastic hospital controls. The dietary questionnaire included 69 different items: special care was given to foods rich in vitamin A and seasonal foods (e.g., vegetables and fruits), whereas serum analysis was focused on retinol and beta-carotene. Age-adjusted mean values for cases and controls were, respectively, 458.3 vs. 551.3 mg for plasma retinol, 276.1 vs. 390.1 mg for plasma carotene; 598.1 vs 820.6 mg for daily retinol, and 628.0 vs. 882.5 mg for dietary carotene. The odds ratios for low vs. high tertile, adjusted for age, smoking, retinol or carotene, cholesterol, and triglycerides by multivariate analysis were, respectively, 1.13 for plasma retinol, 5.04 for plasma carotene, 3.27 for dietary retinol, and 2.93 for dietary carotene. For all the examined items, there was a trend of increased risk for the second and third tertile, and statistical significance was reached for plasma beta-carotene (p less than 0.05). The hypothesis that a higher risk of lung cancer is related to a low vitamin A consumption is supported by these data.

Aged↗
PubMed1987

Radiation dose and leukemia risk in patients treated for cancer of the cervix.

To quantify the risk of radiation-induced leukemia and provide further information on the nature of the relationship between dose and response, a case-control study was undertaken in a cohort of over 150,000 women with invasive cancer of the uterine cervix. The cases either were reported to one of 17 population-based cancer registries or were treated in any of 16 oncologic clinics in Canada, Europe, and the United States. Four controls were individually matched to each of 195 cases of leukemia on the basis of age and calendar year when diagnosed with cervical cancer and survival time. Leukemia diagnoses were verified by one hematologist. Radiation dose to active bone marrow was estimated by medical physicists on the basis of the original radiotherapy records of study subjects. The risk of chronic lymphocytic leukemia, one of the few malignancies without evidence for an association with ionizing radiation, was not increased [relative risk (RR) = 1.03; n = 52]. However, for all other forms of leukemia taken together (n = 143), a twofold risk was evident (RR = 2.0; 90% confidence interval = 1.0-4.2). Risk increased with increasing radiation dose until average doses of about 400 rad (4 Gy) were reached and then decreased at higher doses. This pattern is consistent with experimental data for which the down-turn in risk at high doses has been interpreted as due to killing of potentially leukemic cells. The dose-response information was modeled with various RR functions, accounting for the nonhomogeneous distribution of radiation dose during radiotherapy. The local radiation doses to each of 14 bone marrow compartments for each patient were incorporated in the models, and the corresponding risks were summed. A good fit to the observed data was obtained with a linear-exponential function, which included a positive linear induction term and a negative exponential term. The estimate of the excess RR per rad was 0.9%, and the estimated RR at 100 rad (1 Gy) was 1.7. The model proposed in this study of risk proportional to mass exposed and of risk to an individual given by the sum of incremental risks to anatomic sites appears to be applicable to a wide range of dose distributions. Furthermore, the pattern of leukemia incidence associated with different levels of radiation dose is consistent with a model postulating increasing risk with increasing exposure, modified at high doses by increased frequency of cell death, which reduces risk.

Adult↗
PubMed1987

[Technical ambulatory ECG innovations in performance evaluation].

Evaluating the performances of the instrumentation for Ambulatory ECG (AECG) analysis is a need largely recognized by both manufacturers and users. The most generally accepted method is the beat-by-beat comparison with annotated data bases, representing the different ECG abnormalities. Available data bases are aimed at arrhythmias detection evaluation, while it is recognized that the AECG ST-T changes detection has a great relevance in the analysis of ischemic heart disease. A concerted action of the European Community on Ambulatory Monitoring has been approved for achieving a comprehensive reference standard for assessing the quality of AECG instrumentation. The European project has been concentrated on the problem of ST-T analysis. An annotated data base is being developed with the contribution of european experts. A pilot study has been performed for establishing the criteria related to the development and annotation; particularly the definition of significant ST-T changes has been established. The data base will include 2-hour double channel AECG records, which contain at least one ST-T episode. Each record is annotated beat by beat according to the established scheme, identifying arrhythmic beats, rhythm changes, ST-T changes and noisy segments. A coordinating center has been established for interacting with the participating groups and for performing the operations related to the generation and management of the data base. For the time being 14 Groups of 8 Countries are participating to the annotation of the data base. A minimum number of 100 records is planned within June 1988.

Algorithms↗
PubMed1987

[Results of radiotherapy in the treatment of 218 carcinomas of the tonsillar area].

After a brief review of the literature, the results of the treatment by radiation therapy in 218 patients with tonsillar region carcinoma are reported. The patients were treated at the Turin University Radiotherapy Department (131 cases) and at the Radiotherapy Department of the Ospedale Maggiore, Novara (87 cases) from 1976 through 1984. The series included 29 T1, 88 T2, 64 T3 and 37 T4; 86 patients (40%) were N0. Only 49 patients were stages I and II (1/4 of the total). The local control (T) rate at the end of therapy was 63.5% for the overall series (139/218) ranging from 100% in T1, 72.6% T2, 54.6% T3 to 30% T4; the regional control (N) for patients with cervical lymphadenopathy was 66% (88/132). The overall 5-year survival was 38%; the 5-year disease-free survival was 35%. The 5-year survival according to T-stage was 52% for limited cases (T1-T2) in comparison to 22% for advanced ones (T3-T4). The 5-year survival for N0 stage was 55%; when neck nodes were present (N # 0) the survival was 29% after 5 years. Complications included 6 cases of trismus and 2 osteonecroses of the mandible. Second primary malignant diseases were seen in 17 cases (7.8%). The most common cause of death was failure in primary tumour control (80% of cases). In this series the results of radiotherapy of early stage tonsillar carcinomas are quite good; patients with large tumour masses fare less satisfactorily. Better results should be obtained in the future by identifying prognostic factors, monitoring potential causes of treatment failure and optimizing the radiotherapeutic treatment plan and technique.

Adult↗
PubMed1986

The assessment of gas exchange by automated analysis of O2 and CO2 alveolar to arterial differences.

A computer program to measure breath by breath alveolar pressure (PA) and alveolar to arterial difference (AaD) for O2 and CO2, by a mass-spectrometer has been implemented. The program allows the determination of alveolar gas by different methods: 1. Bohr's equation (BE); 2. ideal alveolar air equation for O2 (IDO2); 3. end-tidal (ET); 4. by the Rahn's definition of 'mean alveolar gas', i.e., alveolar pressures are defined when instantaneous respiratory exchange ratio (IRQ) equals mean respiratory exchange ratio (MRQ). This automated technique has been used in 16 patients with chronic obstructive lung disease (COLD) and 15 patients with pulmonary embolism (APE). In both groups of patients it was always possible to find in each breath the point where IRQ = MRQ and therefore to measure AaD by RD. IDO2 was significantly lower than PAO2 by the other methods. Also ET values of O2 and CO2 were significantly different from RD and BE in both groups of patients, however the difference was consistently higher in COLD patients. The different shape of the expirograms (steeper expirograms in COLD) is responsible for this different result. RD and BE AaD characterize gas exchange more precisely than ET, because the contribution of high VA/Q units is also evaluated. This is particularly important in COLD patients. Consideration on dead space measurements are also reported both for COLD and APE patients. In conclusion this automated technique provides the assessment of gas exchange for the use in clinical respiratory physiology and for the monitoring of gas-exchange in critically ill patients.

Aged↗
PubMed1986

Carrots, green vegetables and lung cancer: a case-control study.

A total of 417 lung cancer cases and 849 controls were interviewed on their life-long tobacco usage and their current intake of four food items rich in retinol or carotene. The study was a hospital-based case control where 'cases' were lung cancer patients diagnosed during the period 1979/80 at seven hospitals in the Lombardy region (90% pathologically confirmed) and controls were patients admitted to the same hospitals for causes unrelated to tobacco smoking (epithelial cancers being excluded from present analysis). Odds ratios (OR) have been computed for increasing frequencies of consumption of liver, cheese, carrots and leafy green vegetables, having controlled for the confounding effects of tobacco usage, residence and birthplace. Current smokers who did not consume carrots showed a three-fold risk of developing lung cancer compared with those who ate them more than once a week (OR = 2.9 less than p less than 0.01); the ORs for consumers in the categories of 1-2 and 3-4 times per month were 1.8 and 2.0 respectively, with a significant test for linear trend (p less than 0.01). Among ex-smokers or non-smokers, no decrease of lung cancer risk is evident associated with carrot consumption. An excess risk was also associated with low intake of green vegetables although it was not significant, while no excess risk was evident for non-consumers of liver and cheese. The effect of carrots is independent of histological type of lung cancer while the effect of green vegetables was confined to epidermoid carcinomas: low versus high intake group OR = 1.3.

Diet↗
PubMed1986

[Carcinoma of the paranasal sinuses. Results with radiotherapy alone or with a radio-surgical combination].

The authors evaluate 117 patients affected by paranasal sinuses carcinoma treated by radiation therapy alone or by post-operative irradiation, from 1976 to 1984. Among these: 4 T1, 21 T2, 48 T3 and 44 T4; 66 cases were squamous cell carcinomas, 23 adenocarcinomas, 16 undifferentiated carcinomas and 12 adenoid cystic carcinomas. The overall 3 and 5 years actuarial survival rates were, respectively, 46% and 27%. The survival rates for stages T1 and T2 were 82 and 48% at 3 and 5 years; for stages T3 and T4 were 36% and 21%. According to the hystological type the survival rate varied from 50% for adenoid cystic carcinomas to 0% for undifferentiated carcinomas at 5 years. The survival rate for the group of patients treated with post-operative irradiation was 37% at 5 years, versus 10% for the group treated by radiotherapy alone. Complications have been minimal. Causes of failure are discussed. In conclusion, the authors consider a multicentric study as necessary to determine the efficacy of various schedules of treatment.

Adult↗
PubMed1986

Estimating incidence of cancer from a hospital discharge reporting system.

We have evaluated the reliability of hospital discharge information of the Lombardy Region, in northern Italy, in identifying incident cases of cancer. This was accomplished by linking all cancer cases automatically identified from hospital discharges to the date of the Cancer Registry of Varèse Province, part of the same Region, up to 1977. The comparison showed a consistent overestimation of rates derived from hospital data, particularly in relation to the least common sites and extreme ages. When the procedure was applied to the most common tumors and truncated ages (35-74), estimated age-specific rates corresponded quite closely to those of Cancer Registry. We concluded that estimates of cancer incidence based on hospital discharge data are reliable when applied to selected tumors and can be useful for descriptive and other epidemiological purpose.

Adult↗
PubMed1981

[Curie therapy with 192 iridium on a moulded apparatus in the treatment of tumors of the hard palate].

Complete regression of the primary tumour was observed when a shaped apparatus loaded with 192Ir wires was used in the treatment of 6 patients with neoplasia of the hard palate, whereas very slight changes were noted in another subject. Fatal locoregional adenopathy appeared after 6 months in one of these 6 patients without prejudice to the cure obtained in the primary site.

Adenocarcinoma↗
PubMed1980

[Radiotherapy of anal carcinomas. Case reviews].

Radiotherapy is commonly assigned an important role in the treatment of anal neoplasia. Interstitial treatment with 192Ir and high-energy transcutaneous therapy will lead to survival and cure percentages comparable with those obtainable surgically, if correctly employed in accordance with precise indications, in stage T1 and T2 tumours. External high-energy management, with or without surgery, may also be effective in stage T3 cases. The seriousness and frequency of radionecrosis have hitherto helped to create a lack of trust in radiation management. Modern irradiation techniques, however, have reduced these complications to low percentages, and their resolution by destructive surgery is rarely required.

Adenocarcinoma↗
PubMed1980

[Post-irradiation lesions of the brachial plexus].

A series of 60 cases in which a departure was made from the usual chronological distribution of preoperative radiation doses for breast cancer is presented. Tardive lesions were noted in the brachial plexus in 33 cases. Their incidence was higher in patients who had received larger dose fractions over a shorter total period. The progress of these lesions was barely influenced by medical and physical management. The underlying pathogenetic problems are examined, with particular reference to the radiotherapeutic technique and dose fractionation. Agreement is expressed with the opinion of other workers that the risk of such lesions can be kept down by employing a scrupulously careful technique, and employing total doses of 4.500-5.500 rads in 5-6 weeks. The conventional pattern of 5 weekly sessions should not be too widely departed from.

Arm↗
PubMed1977

Possibilities, limitations, and technique for the study of regional myocardial perfusion in man by Xenon-133.

The theoretical possibilities and the practical limitations of the Xenon-133 (133Xe) method for the study of regional myocardial perfusion in man are discussed. The techniques for data acqusition and processing developed over the past 5 years are described in detail. Illustrative examples of experimental findings are reported. The practical interpretation of the data, at the light of the influence of injection site, initial tracer distribution, constancy of counting geometry, spatial resolution, and Xenon retention in fat, is presented.

Coronary Circulation↗
PubMed1976

Methods for the study of regional myocardial perfusion in patients with atherosclerotic coronary artery disease: findings at rest after nitroglycerin and during angina pectoris.

In patients with ischemic heart disease the evaluation of regional myocardial perfusion by 133Xenon intracoronary injection using a gamma camera computer system allows the detection of regional alterations of myocardial perfusion. While at rest a minority of the patients studied shows large alterations, during pacing induced angina a severe reduction of regional myocardial perfusion can be evidenced both in initial distribution scintigrams, when the injection is performed during angina, and on the washout curves when angina is induced immediately after the injection, during the course of the washout.

Angina Pectoris↗