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Biomedical subjects

P Poletti

Publications and source records attributed to P Poletti.

At least 19 recordsLinked to original sources
PubMed2004

Population-based sentinel lymph node biopsy in early invasive breast cancer.

INTRODUCTION: Sentinel lymph node biopsy (SLNB) has been proposed as a reliable method for staging of early invasive breast cancer (EIBC). In the present study we analyse the impact of this procedure when systematically applied to all unselected women of a community-based Breast Cancer Unit (BCU). METHODS: All consecutive women with unifocal cT1-2 (<or=3 cm) cN0 EIBC diagnosed at our BCU were considered for radiocolloid sentinel node localisation and biopsy. RESULTS: Only 387 of all consecutive 542 patients met eligibility criteria for SLNB. Reasons for ineligibility included tumour size, palpable axillary nodes, plurifocality and/or multicentricity, and refusal to undergo the procedure. Successful SLNB was performed in 362 patients (94% of those eligible), but in 108 of these axillary dissection (AD) had to be performed anyway, mainly because of SLN-positivity. Therefore, SLNB ultimately allowed sparing axillary dissection in 256 patients out of the entire population of women with EIBC. CONCLUSIONS: Radiocolloid-guided SLNB, when appropriately applied in the context of a population-based service, can help in sparing unnecessary AD, with its related costs and morbidity, in approximately half of all women presenting with EIBC. In absolute terms, in the EU this could result in approximately 100,000 unnecessary AD avoided each year.

Adult↗
PubMed2001

New drugs and combinations in the palliative treatment of colon and rectal cancer.

Colorectal cancer (CRC) is a common disease. The overall survival has improved only marginally in recent decades despite advances in surgery and early detection. Potentially curative resection at disease presentation can be performed only in 70-80% of the patients, and overall survival at 5 years is less than 60%. Advanced disease is associated with a poor prognosis. Treatment for advanced colorectal cancer has nevertheless made progress in the last few years. Systemic chemotherapy doubles the survival of these patients compared to untreated controls. Chemotherapy has demonstrated effective palliation, improvement of quality of life (QoL) and symptom improvement in such patients. For nearly four decades, fluorouracil (5FU) has been the mainstay of treatment. New compounds active against colorectal cancer are now available. Several studies on this topic are ongoing.

Administration, Oral↗
PubMed2000

Gemcitabine plus vinorelbine in elderly or unfit patients with non-small cell lung cancer.

Cisplatin-based combinations are efficacious in increasing the overall survival of patients with non-small cell lung cancer (NSCLC), but their toxicity makes them unsuitable for elderly and unfit patients. The primary objective of this non-randomized phase II study was to evaluate the feasibility and activity of the gemcitabine plus vinorelbine combination in previously untreated elderly and/or unfit patients with measurable stage III or IV NSCLC. Forty-three patients aged >/= 65 years or with contraindications against cisplatin treatment (36 males and seven females: median age 66 years; range 48-75: PS 0 = 11, PS 1 = 19, PS 2 = 13) received intravenous (i.v.) gemcitabine 1000 mg m(-2), followed by vinorelbine 25 mg m(-2)i.v. on day 1 and 8 every 21 days. Fifteen patients (34.9%) achieved partial remission (confidence interval: 27. 6-42.2%) for a median duration of 6 months; the median survival of these patients has not yet been reached. A further 15 had stable disease for a median of 4 months and a median survival of 7 months. The 10 patients (23.2%) who experienced disease progression had a median survival of 4 months. Three patients are not evaluable. The 1-year actuarial survival rate is 31.1%. The treatment was well tolerated: only 35% of the patients had grade 3 or 4 granulocytopenia on day 14, none experienced episodes of neutropenic fever, and there was no evidence of severe haematological toxicity upon recycling. Only 9% of the patients suffered from gastrointestinal toxicity (grade 3); increased but reversible transaminase levels were observed in 11.6%. In conclusion, the results of this phase II study show that the combination of gemcitabine and vinorelbine is active and well tolerated in NSCLC, and thus encourage its use in elderly or unfit patients.

Aged↗
PubMed1995

[Notes from Italy].

Explore the source record for details and available documents.

Education, Nursing↗
PubMed1990

Locally advanced lung cancer treatment: personal experience of 588 stage III operated on patients.

From 1967 to 1988, we operated on 1507 non-small cell lung cancer. Complete data concerning patients at stage III are available for 501 of them. In 73% of cases the histological type was epidermoid, in 22% it was adenocarcinoma and in 5% large cells anaplastic carcinoma. Explorative thoracotomy (E.T.) was performed in 45% of interventions whereas curative resections in 55%. Sixty-two percent of these patients underwent pneumonectomy and thirty-eight percent lobectomy. Exeresis interventions were performed in patients at stage III A in 86% of cases, whereas in patients at stage III B in 14% of cases. Five years survival rate for stage III non small cell lung cancer is 17% whereas in stage II is 33% and in stage I is 52%. The only valuable prognostic factor seems to be the size of parenchymal exeresis. Indeed, survival rate after lobectomy is 24% versus 13% after pneumonectomy. In our experience the different survival between tumours at stage III A and tumours at stage III B are not significant, when the unexpected intraoperative finding of marginal infiltration of mediastinal organ is still compatible with resection. Also the survival rates between the two histological types are not statistically significant.

Carcinoma, Non-Small-Cell Lung↗
PubMed1989

Determination of cyclic butylboronate esters of some 1,2- and 2,3-diols in plasma by high-resolution gas chromatography/mass spectrometry.

A gas chromatographic/mass spectrometric analytical procedure is described to determine glycols in plasma as cyclic butyl boronate esters. The method, involving a pre-deproteinization step, required only 0.25 ml of plasma and a short time (20 min) to react with the derivatizing agent (butyl boronic acid). The gas chromatographic separation on a CP Sil 8 CB silica capillary column coupled to a mass detector assured a complete identification of the compounds. The analytical recoveries (greater than 95%) with low coefficient of variation (4-11%) assured the feasibility of the method over a concentration range from 5 to 1000 micrograms ml-1 for each glycol. The lower detection limits, namely 1-5 micrograms ml-1, confirmed the sensitivity of the method.

Animals↗
PubMed1989

[Why do they enroll in nursing school? A study of the motivations of the enrollments in the School for Professional Nurses of Veneto Province].

A longitudinal investigation developed in the Regione Veneto has focused on the motivations which lead 2,500 young people per year to choose the nursing school and on the information on the school and the profession which are available for them. The ground motivations which seem to guide to choice appear to be mostly of the idealistic-humanitarian type, while the image of the nursing profession shares the characteristics of a low professional and social role. The investigation has also explored the motivations which lead 15% of the candidates to leave the school very early on, and provides a profile of those characteristics of the Regional Schools which are judged by the young candidates as positive or negative.

Humans↗
PubMedDate not supplied

The value of oxaliplatin in combination with continuous infusion +/- bolus 5-fluorouracil and levo-folinic acid in metastatic colorectal cancer progressing after 5FU-based chemotherapy: a GISCAD (Italian Group for the Study of Digestive Tract) cancer phase II trial.

AIMS AND BACKGROUND: The phase II trial was designed to evaluate the activity of combined oxaliplatin (L-OHP), continuous infusion (CI) +/- bolus 5-fluorouracil (5FU) and levo-folinic acid (I-FA) in patients with metastatic colorectal cancer progressing after one or more lines of 5FU-based chemotherapy. PATIENTS AND METHODS: We designed two contemporary studies: in the former we enrolled patients previously treated with 1 line of chemotherapy, and in the latter, patients previously treated with 2, 3 and 4 lines. Seventy-six consecutive patients were enrolled: 45 received L-OHP (85 mg/m2 i.v. 2 h on day 1) + I-FA (100 mg/m2 i.v. 2 h on days 1 and 2) + 5FU i.v. bolus (400 mg/m2 days 1 and 2) + 5FU (600 mg/m2 CI 22 h days 1 and 2 (FOLFOX 4); 31 received L-OHP (100 mg/m2 i.v. 2 h on day 1) + I-FA (250 mg/m2 i.v. 2 h on days 1 and 2), followed by 5FU (1500 mg/m2 Cl 24 h days 1 and 2 (FOLFOX 2). The treatment was recycled every 2 weeks and continued until progression and/or unacceptable toxicity or patient preference. The primary end point was activity (tumor growth control [TGC]: partial response [PR] + stable disease [SD]); the secondary end points were time to progression (TTP), overall survival (OS) and toxicity. RESULTS: Forty-five patients in 2nd line (22 FOLFOX 4, 23 FOLFOX 2), 23 (17 FOLFOX 4, 6 FOLFOX 2) in 3rd, 4 in 4th and 1 in 5th line were assessable; 3 were lost to follow-up. In 15 patients (11 FOLFOX 4, 4 FOLFOX 2), disease involved the liver only. A total of 533 courses were administered with a range of 1-14 in FOLFOX4 and 1-12 in FOLFOX2; dose intensity was 92.85%, and the total dose of the administered L-OHP was 98.29%. As a 2nd line treatment, FOLFOX 4 achieved TGC in 72.8% of the patients (PR, 18.2%; SD, 54.6%), with a median TTP of 6 months and a median OS of 7 months, whereas in the FOLFOX 2 group these figures were 78.3% (PR 21.8%, SD 56.5%), and 5 and 9 months. As a 3rd line treatment, FOLFOX 4 produced TGC in 41.1% of patients (PR 23.5%, SD 17.6%), with a median TTP of 5 months and median OS of 7+ months, whereas FOLFOX 2 obtained respective values of 50% (PR 16.7%, SD 33.3%), 7 and 9 months. As a 4th line of treatment, TGC was achieved in 2 patients (1 PR, 1 SD); the patient in 5th line therapy obtained a SD. With "de Gramont" as the first-line regimen, patients assessable were 24 in FOLFOX 4 and 18 in FOLFOX 2. In the former population, TGC was 70.8% (PR 37.5%, SD 33.3%), with a TTP of 6 months and OS of 10 months, whereas with FOLFOX2 these values were 61.1% (PR 5.6%, SD 55.5), 5 and 7 months. In patients with liver involvement only, FOLFOX 4 obtained TGC in 63.6% of cases (with a TTP of 7 months and OS of 6+ months), FOLFOX 2 in 100% (with a TTP of 9.5 months and OS of 13.5+ months). Both schedules exhibited an acceptable toxicity: neurologic, hematologic and hepatic grade 3 side effects occurred in a limited number of patients, with a higher frequency in the FOLFOX 2 group. CONCLUSIONS: Treatment with L-OHP, CI +/- bolus 5FU and I-FA was well tolerated. The activity in terms of TGC was interesting and comparable with results reported in the literature for the standard treatment for 2nd line, i.e. irinotecan alone. Treatment was effective in 2nd line and in patients previously treated with more than two chemotherapy lines; in particular, treatment was active in patients with hepatic disease only. Although the two schedules seemed to achieve the same benefit with the same tolerance, we could not define from the study the better regime.

Adult↗
PubMedDate not supplied

[5-fluorouracil and colorectal tumors: use in clinical practice and the "MISURA" project].

5-fluorouracil, an antimetabolite inhibiting timidilate synthetase, is one of the most used drugs in the treatment of many solid tumor types. In particular it is still central in the treatment of colorectal cancer. Nevertheless 5-FU efficiency is limited, this is due to the rapidity of its metabolism (T1/2 10 min). Many attempts have been done to increase its efficiency: 1) combinations with other antitumor drugs have been tested, but no one showed improved response rates with respect to 5-FU alone; 2) use of biological modifiers such as folinic acid and methotrexate. They interact with the biological actions of 5-FU improving its therapeutic effects. These combinations appear to be more effective than 5-FU alone; 3) continuous infusion increases the percentage of susceptible tumor cells, it makes possible the use of a high intensity dose which is active in patients resistant to 5-FU administered as bolus-injection. There are many schedules and methods of administration of 5-FU in the treatment of CRC, each of them showing different types of toxicities. This explains why there is the need to obtain a profile of 5-FU in clinical practice. The project called MISURA is though to give us this kind of information. It will be a collection of data regarding patients affected by colorectal cancer and treated with 5-FU. The collected information will be about diagnosis; ways of use, schedules, doses and tolerability of the drug; obtained responses. The aims of the study are: 1) to evaluate the use of 5-FU in clinical practice; 2) to collect data about the use of supportive therapy; 3) to know the effective incidence and prevalence of CRC in Italy. The study is retrospective, the sample consists of all patients from the oncological departments chosen to represent the national territory. The analysis of the data will be descriptive.

Antimetabolites, Antineoplastic↗
PubMedDate not supplied

[Endoscopic gastrostomy in patients with complicated heart diseases].

Complicated cardiologic patients with brain ischemia and heart failure need long term enteral nutrition. Long term nasoenteral tube feeding may cause complications that could be avoided with percutaneous endoscopic gastrostomy. The aim of this study was to evaluate the indications for percutaneous endoscopic gastrostomy and its main complications. Twelve patients were submitted to percutaneous endoscopic gastrostomy (eight male) with main age of 62.42 +/- 22.10 years old. Brain ischemia was the main indication of percutaneous endoscopic gastrostomy and occurred after 35.58 +/- 26.79 days, after initiated enteral nutrition. There were no complications during procedure. On late post operatory period there were local infection in one cases, treated with local care. In conclusion, percutaneous endoscopic gastrostomy is a secure technique with low incidence of complications and its indication should be earlier.

Adult↗
PubMedDate not supplied

Strategies for managing conflict.

As nursing becomes more international, it is becoming increasingly important to know how different cultures respond to various phenomena. Below the authors compare conflict handling modes of Italian nurses with those of American nurse and business managers.

Adaptation, Psychological↗