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Biomedical subjects

R Moretti

Publications and source records attributed to R Moretti.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Evaluation of the accuracy of the study on diverse techniques of planning radiotherapy of breast tumors].

The authors report the results of the analysis of several factors contributing to the accuracy of treatment planning in the radiation therapy of breast cancer. Different techniques (non-radiological vs CT-based) were used for the acquisition of patients' data; different methods (manual vs computerized) were employed for dose calculation. As for geometric parameters describing the external outline and target volume, mean differences were lower than 4%. Switching from a completely manual method to a CT-based one with computerized calculation, a 3.56% mean decrease in the value of reference isodose (p less than 0.01) was observed, together with a 3.87% mean increase in the estimated inhomogeneity (p less than 0.001). The non-CT-based outline of target volume exhibited geographic missing of inner portions of the target in 8/16 patients. Our results demonstrate that treatment planning procedures can be a significant source of clinically relevant inaccuracy, which may affect treatment outcome and tumor control.

Breast Neoplasms↗
PubMed1990

Conservative management of temporomandibular disorders: a posttreatment comparison between patients from a university clinic and from private practice.

Long-term (1 to 7.5 years) follow-up evaluations of 110 adult patients who were seen for diagnosis and treatment of symptoms related to myofascial problems (MP), internal derangement (ID), or both were conducted by means of telephone interview. One half of the patients were seen at the Northwestern University Dental School TMJ Clinic, while the other half were seen in the private office of one author (H. T. P.). The purpose of this study was to evaluate patient response to conservative therapy combined with advice about self-management, as compared with the response to advice only. Further, we desired to compare treatment outcomes among (1) diagnostic categories ID, MP, and ID plus MP, (2) clinic patients and private patients, and (3) patients with acute disease and those with chronic disease. Chronic disease was identified as that in which pretreatment symptoms had persisted for more than 4 months. The ridit analysis was used to assess differences in outcomes for patients in the three diagnostic categories and for clinic patients compared with private patients. The results revealed no significant differences. There was a trend for patients with acute conditions to improve more than those with chronic problems; however, further research is needed to determine whether a correlation exists between symptom duration and treatment outcome. At the time of the follow-up evaluation, 88% of all patients reported substantial or total improvement in their symptoms of pain and dysfunction. Therefore, conservative therapy, including advice about self-management, was found to be both adequate and appropriate for most of these patients.

Acute Disease↗
PubMed1989

[Hemodynamic effects of the intravenous administration of captopril in patients with chronic congestive heart failure].

The aim of the present study was to evaluate the hemodynamic response to the intravenous administration of the angiotensin converting enzyme-inhibitor captopril. Plasmatic renin activity was also monitored. The study population included 10 patients with chronic congestive heart failure: 3 were in the second NYHA functional class, 5 in the third, and 2 in the fourth. The patients received a first dose of 5 mg of captopril followed, after 10 min, by a second bolus-dose of 15 mg. Hemodynamic and hormonal measurements were repeated in the following 4 hours. The greatest hemodynamic effect, considered as the time of maximal mean arterial pressure and systemic vascular resistances decrease, and cardiac index increase, was noted 20 min after the first bolus dose administration. Mean arterial pressure (MAP) decreased by 13% (p less than 0.01), mean pulmonary artery pressure (MPAP) by 14% (p less than 0.05), right atrial pressure (RAP) by 30% (NS), wedge pressure (WPP) by 23% (p less than 0.01), systemic vascular resistances (SVR) by 21% (p less than 0.05), pulmonary vascular resistances by 22% (NS); cardiac index (CI) increased by 12% (p less than 0.05), stroke volume index by 10% (NS). Heart rate didn't change. The plasmatic renin activity (PRA) increased by 339% (p less than 0.01) reaching the maximal level in concomitance with the greatest hemodynamic effect. Hemodynamic changes were already noted 5 min after the first dose and lasted up to 75 min later.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Inhibition of DNA polymerization and DNA transcription to RNA by seminal plasma peptides.

An oligopeptide fraction purified from the extracellular compartment of bull semen and strongly interacting with DNA was shown to hinder mononucleotide polymerizations to DNA and RNA in vitro. The fraction, collectively called seminal plasma inhibitor, was active in the endogenous DNA and RNA polymerase reactions of the nuclei from rat hepatocytes and in the analogous nucleotide polymerizations catalyzed by purified enzymes of bacterial origin. The type of the induced inhibition was studied using the RNA polymerase from Escherichia coli as a representative nucleotidyl transferase. In the enzymatic polycondensation of mononucleotides, the seminal plasma inhibitor appeared to exert its effect mainly by a competitive inhibition for the utilization of DNA templates without specificity with respect to the source and the base sequence of DNA. Concavities of the plots of V0/Vi versus the amounts of inhibitor in the nucleotide polymerizing reactions and of the Dixon plots in the assays of RNA polymerase from E. coli suggested that the isolated oligopeptide fraction contained more than one active molecular species with differential effects at low and high doses. Preliminary results on the microheterogeneity of the seminal plasma inhibitor supported this contention.

Amino Acids↗
PubMed1988

Complete estrogen blockade with buserelin and aminoglutethimide for advanced breast cancer: a phase I-II study with long-term hormonal correlations.

We treated 21 patients with advanced breast cancer with buserelin, aminoglutethimide and cortisone acetate in an attempt to obtain a complete estrogen blockade both in premenopausal and postmenopausal patients. Ten patients (47%) obtained an objective response without any relevant side-effects. Dealing with hormonal data, it must be outlined that serum testosterone levels decreased significantly in postmenopausal patients, suggesting a possible explanation for the activity of luteinizing hormone-releasing hormone analogue in this group of patients.

Adult↗
PubMed1988

[Radiotherapy in T1 epidermoid carcinomas of the vocal cords].

In the last years radiotherapy has become the methodology of choice in the treatment of initial T1a and T1b glottis neoplasias, the reason being-it is as successful in controlling the disease as demolition surgery, but it saves the phonation function. Our experience in the "O. Alberti" Institute of "Spedali Civili" di Brescia from January 1, 1970 to December 31, 1984 is here reported. Out of the total figure of 195 patients treated with radiotherapy, 154 were T1a, and 41 T1b. Global survival rate after 5 years is 76,25%. Loco-regional relapses were on the whole 28: 24 on T, and 4 on N. Saving therapy allowed the retrieval of 15 patients (62,5%) with relapse on T. The total dose administered (greater than 60 Gy or 60 less than Gy), TDF values (greater than 95 or less than 95 on minimum), and field dimensions (greater than 5 x 5 cm2 or less than 5 x 5 cm2) were considered, in order to evaluate the chance of relapse. The only statistical data concerning the significant difference between the two groups of patients irradiated with fields less than 5 x 5 cm2 and more than 5 x 5 cm2, both with a total dose of more than 60 Gy. In the group of patients irradiated with smaller fields, the percentage of relapses is lower. This is probably due to the fact that the patients had more superficial lesions. The treatment had no severe side-effects, and never affected the quality of the voice. In order to obtain a high recovery-rate, in the meantime reducing side-effects and keeping a good phonation function, small fields and dose ranging between 64 and 68 Gray with 32-34 fractions, 5 per week, are thought to be the best. It is necessary, however, to watch out for penumbra and inaccuracy by immobilizing the patient with containing systems.

Carcinoma, Squamous Cell↗
PubMed1988

[Significance of preventive radiotherapy of the neck in clinically N0 tumors of the larynx].

The role of precautionary radiotherapy of the neck in laryngeal cancers (except T1-T2 glottic and some T1 supraglottic cancers) N0 at the clinical staging was investigated. Two-hundred and fifty-three patients were examined: 143 were irradiated only on T, and 110 also on the neck. Radiotherapy of the neck in the latter group was performed either by means of two large opposed fields of photon beams including T and N, or by means of fields of photon beams on T and electron beams (8 x 12 cm2 average) on the neck, to quite exclude any risks for the spinal cord. The dose was 45-50 Gy (2 Gy/fraction/day; 5 fraction/week) in 4-5 weeks. A comparison of the results obtained in the two groups, in terms of survival-rate and relapse-free time, indicates that radiotherapy reduces the change of relapses on N (6.1% vs. 14.62% at 3 years; p = 0.04) and improves the patient's survival chances (82.5% vs. 68.4% at 3 years; and 80.8% vs 63.4% at 5 years). Our data were then compared with literature data on the importance of N field size in radiation treatment. As a rule, some authors enlarge the field to be treated to a total nodal neck irradiation, but their results are not significantly different from those we obtained with 8 x 12 cm2 field size.

Cobalt Radioisotopes↗
PubMed1986

[Serum cholylglycine in the evaluation of impaired hepatic function].

The biliary serum salts cholylglycine and sulfolithocholylglycine were assessed in 88 chronic liver disease patients subjected to laparoscopy and biopsy. The assay was conducted before and after meals in order to assess the diagnostic value of the test together with the common liver function parameters. The greatest diagnostic sensitivity was provided by gamma glutamyl transpeptidase and bromosulfophtalein K1 clearance. In particular fasting glycocholic acid was as predictively reliable as BSF-K1. Cholylglycine levels also correlated with the prognosis of the liver disease.

Clinical Enzyme Tests↗
PubMed1982

[Research on HBsAg: comparison between two methods of the third generation, RPHA and IEA].

Two tests of the 3rd generation were evaluated for the identification of HBsAg: the reverse hemoagglutination and the enzymatic immunoassay. The results of the study, carried out on 2,434 sera of occasional and periodic donors, have been slightly discordant. It was confirmed the greater sensibility of the IEA test over the RHA and there was a high incidence of false positive results of the IEA test probably caused by the presence in the sera of an elevated concentration of lipid and/or Hb. However, we can consider the RHA a useful test adaptable as an emergency test while the IEA method, being more sensible, can be used as a basic screening test.

False Positive Reactions↗
PubMed1982

[Perforation of the small intestine caused by closed abdominal injury (review of 16 surgically treated cases)].

The cases of 16 patients undergoing surgical treatment for blunt rupture of the small bowel have been reviewed. Male sex was the most affected one, and the traffic accidents were the main cause of this lesion. A high incidence of multiple injuries was noted. Clinical features were often effective in establishing the diagnosis; when performed, peritoneal lavage was always usefull, whereas X-ray did not. Mortality rate was low, in spite of the regular attendance of associated injuries, depending upon early diagnosis and surgical treatment. Only one death is reported, due to the extend of shock, for the associated injuries.

Abdominal Injuries↗
PubMed1982

[Perforation of the small intestine caused by closed abdominal trauma (review of 16 cases undergoing surgical treatment)].

The cases of 16 patients undergoing surgical treatment for blunt rupture of the small bowel have been reviewed. Male sex was the most affected one, and the traffic accidents were the main cause of this lesion. A high incidence of multiple injuries was noted. Clinical features were often effective in establishing the diagnosis; when performed, peritoneal lavage was always usefull, whereas X-ray did not. Mortality rate was low, in spite of the regular attendance of associated injuries, depending upon early diagnosis and surgical treatment. Only one death is reported, due to the extend of shock, for the associated injuries.

Abdominal Injuries↗