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Biomedical subjects

U Tirelli

Publications and source records attributed to U Tirelli.

At least 343 records · Page 19Linked to original sources
PubMed1979

Clinical and immunological evaluation of 5 cases of mycosis fungoides in advanced stages.

Five patients with mycosis fungoides, hospitalized in the Division of Radiotherapy and Medical Oncology of the Ospedale Civile, Pordenone, from January 1975 to December 1978, were studied and treated as non-Hodgkin lymphomas. All patients had evidence of disseminated disease: 3 with bone marrow infiltration, 1 with splenic involvement and 1 with lymph node involvement. Three patients were treated with CVP, resulting in 2 complete remissions that lasted 18 months and 1 PR greater than 50% maintained for 7 months. One patient was treated with ABVD with a PR greater than 50% maintained for 10 months. The last patient was treated with prednisone and then with CV, but expired from pulmonary embolism after 1 cycle. Lymphocyte function, using E and EAC rosette and PHA, was evaluated before therapy in all patients: in the 2 patients who obtained a CR, an improvement in T-lymphocyte function was noted after therapy. The chromosome pattern of peripheral blood lymphocytes was altered before therapy in only one patient. Even if the follow-up period is still relatively brief, the duration of the 2 complete remissions must be stressed. In addition, a strict correlation between T-lymphocyte function and response to therapy was revealed in our study.

Adult↗
PubMedDate not supplied

Staging and treatment with cyclophosphamide, vincristine and prednisone (CVP) in advanced cutaneous T-cell lymphomas.

Twenty-three consecutive patients with cutaneous T-cell lymphomas were submitted to staging procedures including lymphangiography, bone marrow biopsy and aspiration, peripheral blood morphological examination, peritoneoscopy with liver and spleen biopsy, and in selected patients lymph node biopsies. Extracutaneous disease (lymph nodes, bone marrow, liver and spleen) was detected in 12 patients. Bone marrow was involved in 25 per cent of the patients at presentation (all patients had lymph node involvement) and in two of nine patients with advanced disease during the follow-up. Peripheral blood was involved in 65 per cent of the patients at presentation (ten patients with advanced disease) and in six of nine patients with advanced disease during the follow-up. In 16 patients with advanced disease (T3-T4 and/or extracutaneous disease), CVP was given with a 50 per cent objective response rate and four complete remissions of 47+, 12+, 19 and 19 months duration. Median survival of patients with advanced disease was 4 years.

Adult↗
PubMedDate not supplied

Clinical significance of positive direct antiglobulin test in patients with HIV infection.

A direct antiglobulin test (DAT) was performed in 70 patients with anti-HIV antibodies (group A: seropositive patients without or with minimal disease and group B: AIDS patients with or without malignancies). A positive DAT was found in 24 of 70 patients (34%, significantly higher compared to 0.1% in healthy controls) and a higher prevalence of positive DAT was observed in group B than in group A patients (55% versus 21% p < 0.01). When comparing DAT-positive and negative patients within the same clinical group, no significant difference is seen in haemoglobin levels. There is no difference in serum bilirubin, haptoglobin or reticulocyte count between DAT-positive and negative patients altogether or in the same clinical group. AZT therapy seems to exert no significant influence on the onset of a positive DAT. The results confirm a high prevalence of positive DAT in patients with HIV antibodies, mainly in worse clinical conditions, and suggest that a positive DAT might be a prognostic factor in the clinical course of the disease.

Adult↗
PubMedDate not supplied

Interactions of antineoplastic chemotherapy with zidovudine pharmacokinetics in patients with HIV-related neoplasms.

To evaluate the perturbations in zidovudine (ZDV) pharmacokinetics as a consequence of antineoplastic chemotherapeutic treatments, we performed a prospective crossover study in 13 HIV-infected patients with cancer. The subjects received 2-day regimens of ZDV (250 mg x 2/day). On the first day ZDV was administered alone, whereas on the second day it was combined with antitumor chemotherapies specific for the histological type (ZDV + chemotherapy). Blood sample and urine collections were performed over a 12-hour period following oral administration of the antiretroviral agent. ZDV was measured with high-performance liquid chromatography. Pharmacokinetic parameters of ZDV were calculated by a noncompartmental model. The mean ZDV area under curve (AUC) was not significantly different in the patients treated with ZDV alone and ZDV + chemotherapy. Comparison of plasma elimination half-life (t((1/2))), apparent systemic clearance (CL/F), and apparent volume of distribution (Vd/F) of ZDV did not show any significant difference before and after chemotherapy. Conversely, some significant differences were observed for both mean peak concentration (C(max)) of ZDV and the corresponding time (T(max)). There was a 57% reduction in C(max) (p<0.05) and a 66% increase in T(max) (p<0.05) after chemotherapy compared with treatment with ZDV alone. No differences were observed in the urinary excretion of ZDV and ZDV glucuronide and urinary metabolic ratio, as a consequence of antineoplastic treatment. In conclusion, this study demonstrates that some minor perturbations in ZDV pharmacokinetics (i.e. C(max) and T(max)) derived from antineoplastic chemotherapy. Based on the observation that antineoplastic chemotherapy had no significant effect on plasma ZDV concentration expressed as AUC, the observed pharmacokinetic interaction would not warrant by itself a change in the ZDV dosage during chemotherapy.

Adolescent↗
PubMedDate not supplied

Tamoxifen therapy in postmenopausal advanced breast cancer: efficacy at the primary tumor site in 46 evaluable patients.

Forty-six evaluable postmenopausal patients with locally advanced, inoperable T3-T4 breast carcinoma were treated with tamoxifen 10-20 mg twice daily for a period at least 6 weeks. Eight patients (17%) had an objective response at the primary tumor site after 6 weeks of treatment. Improvement of response with a further single tamoxifen therapy was observed in 7 patients, resulting in an overall objective response in 14 of 46 (30%). Median duration of response was 8 months (range 2-24). No response was obtained in the 5 patients with inflammatory signs. Toxicity of treatment was minimal. Medial survival was 10 months (responders 17.5, non-responders 9). Tamoxifen seems to be safe and effective treatment for locally advanced breast cancer without inflammatory signs in postmenopausal women.

Aged↗
PubMedDate not supplied

[Evaluation study of the opinion on Di Bella's multimodal therapy of patients with tumors. 2].

PURPOSE: To evaluate the opinion of patients with tumors who chose spontaneously to undergo the traditional anti-cancer treatment about Di Bella's therapy after the negative results of the experimental trial. MATERIALS AND METHODS: From November 23rd, 1998 to December 10th, 1998 a questionnaire was distributed among 50 patients with tumors. The questionnaire was anonymous, self-administered and included 9 questions. The data were compared, when possible, with those obtained in a previous study. RESULTS: Overall, 40 (70%) patients accepted favourably the conventional therapy; 27 (54%) patients did not believe in the experimental trial, as it was performed; 34 (68%) patients think the experimental trial should be repeated. CONCLUSIONS: The negative results of the experimental trial caused a distrustful feeling towards the Di Bella multi-therapy; but there is much confusion. There is a strong feeling that the conventional medicine is linked to powerful interests of the international pharmaceutical firms.

Adult↗
PubMedDate not supplied

[The cervicofacial manifestations of Kaposi's sarcoma and of non-Hodgkin's lymphomas in HIV-infected patients].

Infection from human immunodeficiency virus (HIV) is well known for the particular host susceptibility to a variety of opportunistic infections and unusual malignant neoplasms. Although no tumor develops exclusively in concomitance with HIV infection, malignancies in these patients have different clinical behaviour, response to treatment and prognosis than the pattern observed in HIV negative hosts. Kaposi's sarcoma (EKS) and non-Hodgkin's lymphoma (NHL) are tumors per se diagnostic of AIDS in patients with HIV infection. From 1987 to 1991, 210 HIV positive patients underwent ENT examination without symptom-related selection: 128 were intravenous drug users, 50 homosexual males, 22 heterosexuals, 4 intravenous male homosexual drug users, 3 blood recipients and 3 subjects without known risk factors. Sixteen were allocated in group II, 37 in III, 9 in IV A, 2 in IV B, 31 in IV C1, 37 in IV C2, 48 in IV D and 30 in IV E. Fourteen had head and neck EKS localization. All were males, with a median age of 40 of which 11/14 were homosexuals. The concomitant involvement of skin and mucosa was the most common manifestation and the palate was the most frequently affected mucosal site. Twenty-four had NHL localized within the head and neck: 21 males and 4 females with a average age of 38, 10 intravenous drug users, 9 homosexual males, 3 heterosexuals, 1 blood recipient, 1 subject without known risk factors. Extranodal localization was the most frequent characteristic while the gums were the most commonly involved site. The main characteristics of head and neck manifestations of EKS and NHL are reported with references to literature. The majority of HIV infected patients with EKS or NHL have ENT localizations, perhaps because lymphatic tissue, a HIV target, is well represented in this area and contamination by infectious agents (such as Epstein-Barr virus and cytomegalovirus, probably involved in the pathogenesis of EKS and NHL) can easily occur in the head and neck. The otolaryngologist should be aware of the various, and sometimes misleading, characteristics of these diseases.

Adolescent↗
PubMedDate not supplied

[Role of the otorhinolaryngologist in HIV infections].

The spreading of HIV infection and the importance of otorhinolaryngological examination in serum positive patients has given rise to some literature regarding the E.N.T. manifestations of this infection. In particular these works underline the nasopharyngeal lymphatic tissue hypertrophy (NLTH). The present work reports data drawn from two years of experience with 69 HIV patients most of which were intravenous drug users (IVDU). The nasopharyngeal findings, divided into 4 classes both in regard to clinical and anatomopathological characteristics, showed that there was a higher incidence of NLTH in HIV+ patients than in the control group. NLTH was particularly found during the initial stages of the disease, in patients ranging in age from 20 to 29 and in IVDU. The most common manifestations found both in the 69 patients examined and in the literature are listed and the main clinical aspects of the various stages of the disease, from contacting AIDS are dealt with. The peculiarity of NLTH is discussed and a viral etiology is suggested even though further study is required to better clarify the physiopathology of the nasopharyngeal lymphatic tissue during an HIV infection. Finally, the importance of a thorough examination of the initial portion of the aerodigestive tract is stressed in all HIV+ cases.

Acquired Immunodeficiency Syndrome↗