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Biomedical subjects

P Politi

Publications and source records attributed to P Politi.

45 records · Page 3Linked to original sources
PubMed1988

A comparative trial of posttransplant immunosuppression in patients transplanted for thalassemia. Cyclosporine alone versus cyclosporine, cyclophosphamide, and methotrexate.

This study compares the efficacy of 2 posttransplant immunosuppressive regimens for prevention of graft-versus-host disease (GVHD). Forty-four patients, ages 8-15 years, with homozygous beta thalassemia received marrow allografts from HLA-identical siblings following an ablative regimen of busulfan and cyclophosphamide. Twenty-two patients received cyclosporine (CsA) alone and 22 received cyclosporine, cyclophosphamide, and methotrexate for prophylaxis against GVHD. Two who received CsA alone have died (1 of graft rejection and 1 of acute GVHD) as did 4 patients who received 3 drugs (1 of rejection, 1 of acute GVHD, 1 of infection and cardiac failure before engraftment, and 1 of acute respiratory failure before engraftment). One patient in each group rejected the transplant and survives with thalassemia. The probability of developing acute GVHD was 41% for the CsA group and 15% for the 3-drug group (P = less than 0.05). Patients receiving CsA alone had a probability of event-free survival of 86% compared to 77% in the group receiving 3 drugs (P = 0.40) with a followup of 209-706 days. Although the study showed a decrease in the incidence of GVHD in recipients of the more intensive prophylactic regimen, this study was terminated since it was apparent that even if larger numbers of patients were studied it would be difficult to demonstrate a significant survival advantage with the use of this drug regimen.

Adolescent↗
PubMed1987

Marrow transplantation in patients with advanced thalassemia.

In a study of the outcome of marrow transplantation in patients with advanced thalassemia, 40 patients with homozygous beta-thalassemia who were 8 to 15 years of age (median, 10) received HLA-identical allogeneic marrow after treatment with busulfan and cyclophosphamide. Twenty-eight of the 40 patients were alive and free of disease 260 to 939 days after transplantation, and 2 patients were alive with thalassemia 372 and 1133 days after transplantation. The actuarial probabilities of survival and of disease-free survival at two years were 75 percent and 69 percent, respectively. Ten patients (25 percent) died. Three died of cardiac failure, interstitial pneumonitis, or septicemia within 14 days of transplantation. Three died of infectious complications associated with acute graft-versus-host disease at 46 to 97 days, and two died of infectious complications of chronic graft-versus-host disease at 249 and 290 days. Two patients had transplant rejection and died with marrow aplasia 115 and 192 days after transplantation. One patient had rejection after four months and while the marrow was aplastic underwent a successful second transplantation; the patient was alive without thalassemia 624 days after the first transplantation. The actuarial probability of grade 2 or higher acute graft-versus-host disease in the 32 patients with initial sustained engraftment was 35 percent. Three patients had chronic graft-versus-host disease, which was fatal in two and still active on day 710 in the third. We conclude that bone marrow transplantation can potentially save patients with advanced thalassemia from an otherwise inexorable progression to death from the complications of blood transfusions. The ultimate outcome in this group of patients must await a longer follow-up.

Adolescent↗
PubMed1987

Bone marrow transplantation in leukemia: experience of Pesaro.

The authors report the results of 113 patients who underwent bone marrow transplant for acute nonlymphoblastic leukemia, acute lymphoblastic leukemia and chronic myeloid leukemia in complete remission and relapse after different conditioning regimens.

Acute Disease↗
PubMed1987

Study on pulmonary, prostatic and renal (medulla and cortex) distribution of sagamicin at different time intervals.

In order to assess the therapeutic activity of an antibiotic, not only its serum kinetics but also its kinetics in the peripheral tissues must be determined, thus evaluating the specific power of penetration of the drug. Sagamicin is an aminoglycosidic basic antibiotic closely related to gentamicin and its penetration rate into lungs, kidney and prostate, together with its serum concentrations time-course, were investigated. The findings obtained showed that this antibiotic attained a good distribution in the peripheral tissues, where it easily reached therapeutic levels.

Aminoglycosides↗
PubMedDate not supplied

[Request for psychiatric admission: data from eight general hospital psychiatric wards in Lombardy].

OBJECTIVE: To describe requests of admissions to eight General Hospital Psychiatric Wards (SPDC) in Lombardy, Italy, during November 1995. DESIGN: Descriptive prospective multicenter study. SETTING: SPDCs of Busto Arsizio (VA), Calcinate (BG), Desio (MI), Magenta (MI), Merate (LC), Milano San Paolo I, Pavia, Treviglio (BG). The global catchment area sums up to 11% of the whole regional area, and to 18% of the population. MAIN OUTCOME MEASURES: We used a previously developed flow chart with two major key points: who decided to go to the hospital? Did a doctor confirm this initiative? Main sociodemographic characteristics, ICD10 diagnosis and previous psychiatric admissions were collected for each admission. RESULTS: Admissions were 315, patients 246. In 9.5% of cases patients asked for admission without any medical advice. In one third of cases the ward psychiatrist was the first doctor to visit the patient. Compulsive admissions (TSO) were 45 (14.3%), although patient's initiative lacked in 55.6% of cases. A referral from Outpatient Departments (CPS) was present in 28.2%. First-ever admitted were 63 (25.6%): 20.7% sent by CPS, 16% by GPs, 11% by other non psychiatric wards. CONCLUSIONS: Although Goldberg & Huxley's model described General Hospital Psychiatric Wards as the last level of intervention, our data show that Italian SPDCs work as "front lines" services: less than one admission out of two were referred by a psychiatrist. Problems raised by "self-referred" patients are conspicuous and an evaluation of the filtering function of CPSs seems necessary. In this regard, a comparison with different modalities of Department organization could be useful.

Commitment of Persons with Psychiatric Disorders↗
PubMedDate not supplied

[Laparoscopy in oncological pediatrics].

Laparoscopy permits direct inspection of the peritoneal cavity. Its role is very important in oncology both in the adult and in the pediatric patient. From 1973 to 1985, 147 laparoscopies were performed on 137 patients, aged 2-16; indications were: definition of the nature of neoplastic disease in 8 cases, staging of known neoplasia in 132, restaging in 7. On Hodgkin's disease, splenic involvement in 8/113 cases was revealed by laparoscopy with biopsy. Histological examination was positive in 4 out of 22 cases of ovarian tumors. Morbidity was 1.2%. Although a laparotomy performed after laparoscopy has shown some false negatives, in most cases the clinical and instrumental follow-up has proved reliability of laparoscopic examination.

Adolescent↗