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V Beltrami

Publications and source records attributed to V Beltrami.

At least 37 records · Page 2Linked to original sources
PubMed1995

Comprehensive pharmacokinetics of urinary human follicle stimulating hormone in healthy female volunteers.

PURPOSE: The study determined the pharmacokinetics of urinary human follicle stimulating hormone (u-hFSH) in 12 down-regulated healthy female volunteers. METHODS: Following pituitary desensitization, baseline FSH serum levels were measured over a 24-hour period. Then each subject received, in random order, single doses of u-hFSH (Metrodin), 75 IU, 150 IU and 300 IU iv, and 150 IU im on four occasions separated by washout periods of one week. Blood and urine samples were collected at preset times. FSH levels were measured by a immuno-radiometric assay and an in vitro rat granulosa cells aromatase bioassay. RESULTS: All doses of u-hFSH were well tolerated. After an iv bolus, the pharmacokinetics of FSH were well described by a two-compartment open model. Immunoassay data showed that the total exposure to FSH was proportional to the administered dose. Mean total clearance of FSH was approximately 0.5 L.h-1 and renal clearance was 0.14 L.h-1. The volume of distribution at steady-state was around 8 liters. The distribution half-life was 2 h and the terminal half-life nearly one day. After im injection, almost two thirds of the administered dose was available systemically. The in vitro bioassay confirmed this pharmacokinetic analysis. CONCLUSIONS: The estimation of the elimination half-life of around one day indicates that the maximal effect of a given dose of u-hFSH administered daily cannot be observed until 3 to 4 days of repeated administration. This indicates that, on a pure pharmacokinetic basis, physicians should wait at least 4 days to assess the efficacy of a given dose of u-hFSH and that they should not modify dosage too frequently.

Adult↗
PubMed1995

Multimedia presentation of lung sounds as a learning aid for medical students.

New educational technologies might help to compensate for the decrease in time and emphasis dedicated to physical examination in medical training. This may, in particular, be applicable for improving the skills in auscultation of the chest. We investigated whether a multimedia presentation of acoustic and graphic characteristics of lung sounds could improve the learning of pulmonary auscultation by medical students, in comparison with conventional teaching methods. We studied 48 medical students without clinical experience, who had received conventional formal teaching on chest examination. Chest auscultation skills were evaluated using an inaccuracy score for the student's auscultation report on three patients, selected according to a standardized procedure. After a baseline evaluation, 27 students in groups of 5-10, participated in a multimedia seminar on lung sounds during which digitized lung sounds were played and the corresponding time-expanded waveform and frequency spectrum were commented on and displayed on a computer. The remaining 21 students received conventional bedside training, acting as control group. The following week, all the students underwent a second evaluation of chest auscultation skills. No differences in the inaccuracy score were observed between the two groups in the preliminary test. However, in the second postintervention assessment, the inaccuracy score of the students who had followed the seminar (11.2 +/- 1.3 points) was significantly lower than that of the controls (16.6 +/- 1.6 points). The answers to a feedback questionnaire confirmed that the great majority of the students found the association of the acoustic signals with their visual image to be useful for learning and understanding lung sounds.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1995

[Inflammatory pseudotumor of the lung].

An inflammatory pseudotumour of the lung was occasionally observed at radiology and is reported. Such lesions account for 1% of all lung tumours and are frequently asymptomatic; the findings on physical and laboratory examinations are usually nonspecific. Radiographic findings and invasive diagnostic procedures--including bronchoscopy and transthoracic fine needle biopsy--may be not sufficient for histological diagnosis. Surgery is then important for both diagnostic and therapeutic reasons; the treatment of choice is complete but non extensive excision. Radiotherapy should be considered in patients who had incomplete surgical resection or postoperative recurrences and in patients non resectable due to associated medical conditions.

Adult↗
PubMed1995

[Preliminary results of the induction treatment in cases of NSCLC (stage III A and B)].

Up to 1994, we surgically treated for lung cancer, 1222 patients, selected from a total of 3157 observed cases. N.S.C.L.C. were 2891 and 899 of these were resected. Some neoadjuvant therapy has been applied in recent years to 170 patients: 83 of these were treated with CT (cisplatin, epirubicin and VP-16, in two cycles with a three week interval) and 41 had RT (30 Gy in daily fractions of 2); 16 patients had the two treatments in sequence. Radiation was mainly used for T problems, chemotherapy for management of N2; the sequence has so far been applied in selected cases. There have been 73 thoracotomies after a successful neoadjuvant, that is in more than 52% of the re-evaluated patients. Resection was possible in 32 of the RT-prepared patients, in 21 of the CT-prepared and in 8 who completed the double treatment: that means a resection was possible in 47% of cases. Because of the recent introduction of neoadjuvant therapy, late survival cannot be evaluated at present.

Carcinoma, Bronchogenic↗
PubMed1995

[Hypothesis of the correlation of personality characteristics and the clinical history of bronchogenic cancer].

A correlation between the personality profile and the clinical history in lung cancer patients was studied. Selection of cases included in the sample only surgical patients with a medium educational level and a tested capability to understand a specific questionnaire. One hundred and seventy patients were selected and the so-called C.R.I.C.S. (Clinical-Rated Inventory of Character Style) was applied. Score variations were recorded after curative resection as well as during relapse. Changes in the character profile pattern were found in all subjects who experienced the disease and its surgical treatment. These changes occurred either in "regression"-with an increase of schizoid, narcissistic or hysterical aspects-or in a "positive evolution", with a decrease of paranoid traits and into a depressive position. The two groups of responses demonstrated a similar percentage.

Adult↗
PubMed1994

Clinical pharmacology of recombinant human follicle-stimulating hormone (FSH). I. Comparative pharmacokinetics with urinary human FSH.

OBJECTIVE: To assess and compare the pharmacokinetics of recombinant human FSH with those of a reference preparation of urinary human FSH. DESIGN: Urinary human FSH and recombinant human FSH (Metrodin and Gonal-F; Laboratoires Serono, Aubonne, Switzerland) were administered in a balanced, random order, crossover sequence as a single i.v. dose of 150 or 300 IU separated by 1 week of washout to 12 pituitary down-regulated, healthy female volunteers. Serum FSH concentrations were measured by an immunoradiometric assay (IRMA) and by an in vitro rat granulosa cell aromatase bioassay. Urine FSH concentrations were measured by IRMA. RESULTS: The mean concentration-time profiles after 150 IU of urinary human FSH and recombinant human FSH were superimposed, and the mean profile after 300 IU of recombinant human FSH was double that of the 150 IU dose. The data for both FSH preparations were well described by a biexponential equation. Total clearance of the preparations was comparable, judging from immunoassay and bioassay data (0.5 and 0.15 L/h, respectively). Based on the immunoassay, renal clearance of urinary human FSH was 0.1 L/h, whereas for recombinant human FSH it was slightly lower at 0.07 L/h, indicating that less than one fifth of the administered dose was excreted in the urine. Immunoassay showed that the two preparations were similar in terms of initial and terminal half-lives (2 and 17 hours, respectively). The volumes of distribution at steady state (11 L) were similar. The results of the in vitro bioassay confirmed this pharmacokinetic analysis. Just after i.v. administration, an initial decrease in the serum bioassay:immunoassay ratio was observed because of dilution of urinary human FSH or of recombinant human FSH in the residual endogenous FSH pool. Then the ratio increased progressively with time, suggesting either metabolic selection or activation of both types of injected human FSH toward forms with greater in vitro bioactivity. The bioassay:immunoassay ratio returned to baseline by day 7. CONCLUSION: The results obtained in this study indicate that the following [1] the pharmacokinetic characteristics of recombinant human FSH are similar to those of urinary human FSH; [2] the terminal half-life of human FSH is approximately 1 day; [3] after a single i.v. injection of human FSH a progressive increase in FSH bioassay: immunoassay ratio is observed; and [4] clinical use of recombinant human FSH could follow protocols and treatment regimens currently applied to urinary human FSH.

Adult↗
PubMed1994

Clinical pharmacology of recombinant human follicle-stimulating hormone. II. Single doses and steady state pharmacokinetics.

OBJECTIVE: To assess the single-dose pharmacokinetics of a recombinant human FSH preparation (Gonal-F; Laboratoires Serono, Aubonne, Switzerland), administered by i.v., IM, and SC routes and its pharmacokinetics at steady state after multiple dosing by the SC route. DESIGN: Twelve healthy down-regulated female volunteers received in random order three single doses of recombinant human FSH (150 IU, i.v., IM, and SC), with each administration separated by 1 week. The volunteers then received multiple recombinant human FSH doses by the SC route (150 IU one time per day) for 7 days. Follicle-stimulating hormone concentrations were measured by an immunoradiometric assay and an in vitro granulosa cell aromatase bioassay. RESULTS: After a single administration, the pharmacokinetics of recombinant human FSH were well-described by a two-compartment model after i.v. administration and by a one-compartment model with first order absorption after IM or SC administration. The mean total clearance of FSH was approximately 0.6 L/h, and renal clearance accounted for one tenth of the total elimination after i.v. administration. The distribution half-life was close to 2 hours. The terminal half-life was nearly 1 day when estimated either by modeling the i.v. data set or from analysis of the terminal phase of the steady state pharmacokinetic curve or from the time taken to reach steady state after repeated SC administrations. After single IM and SC injection, two thirds of the administered dose was available systemically. The cumulation factor for repeated SC administration was approximately 3 when steady state was reached. The in vitro bioassay data confirmed these estimations. The temporal evolution of the bioassay:immunoassay ratio suggests either metabolic selection or activation of recombinant human FSH toward forms with greater in vitro bioactivity. CONCLUSION: The estimation of the elimination half-life of approximately 1 day indicates that the maximal effect of a given dose of recombinant human FSH administered daily cannot be observed until 3 to 4 days of repeated administration. This indicates that, on a pure pharmacokinetic basis, physicians should wait at least 4 days to assess the efficacy of a given dose of recombinant human FSH and that they should not modify dosage too frequently.

Adult↗
PubMed1993

Comparative pharmacokinetics of two urinary human follicle stimulating hormone preparations in healthy female and male volunteers.

These studies were designed to compare the pharmacokinetic characteristics of a very highly purified urinary human follicle stimulating hormone (FSH-HP) preparation (sp. act. approximately 9000 IU FSH/mg of protein), Metrodin HP, with a standard urinary FSH preparation Metrodin (FSH). The two preparations were administered in a balanced, random-order, cross-over sequence as single doses of 150 IU, separated by 1 week of washout to 12 female volunteers by i.v. injection and to 12 male volunteers by i.m. and s.c. routes. FSH concentrations were measured by immunoradiometric assay and by an in-vitro rat granulosa cell aromatase bioassay. After an i.v. bolus, the pharmacokinetics of the two FSH preparations were identical. Total clearance was 0.5 and 0.15 l/h respectively for immunoassay and bioassay data. Immunoassay showed that the two preparations were similar for renal clearance (0.1 l/h), volumes of distribution at steady state (9 l), distribution and terminal half-lives (2 and 17 h, respectively). After parenteral administrations, the absorption half-life of FSH was approximately 3 h and the apparent terminal half-life was approximately 1.5 days. Both preparations had relative bioavailabilities close to 100% for i.m. and s.c. administrations. Immunopurification, which results in a very highly purified FSH-HP, does not modify the pharmacokinetic properties of FSH. This study also confirmed that s.c. and i.m. doses of FSH-HP are equivalent from the pharmacokinetic and pharmacodynamic points of view.

Adult↗
PubMed1992

Neoadjuvant chemotherapy with cisplatin, epirubicin and VP-16 for stage IIIA-IIIB non-small-cell lung cancer: a pilot study.

Twenty patients with stage IIIA-IIIB non-small-cell lung cancer were treated with cisplatin, epirubicin and VP-16 (PEV) neoadjuvant chemotherapy (CDDP, 70 mg/m2, i.v., d 1; EDX, 60 mg/m2, i.v., d 1; VP-16, 100 mg/m2, i.v., d 1-2-3; every 3 weeks). A partial response was obtained in 11 cases (55%), stable disease in 3 cases (15%), and progressive disease in 6 cases (30%). After chemotherapy, 8 (40%) patients, all achieving a partial response, were elegible for surgery: 5 (25%) had a complete resection (4 IIIA and 1 IIIB) and 3 (15%) an incomplete resection. The treatment was well tolerated. These data show that PEV is an active regimen for neoadjuvant chemotherapy in NSCLC and recommend this therapeutic approach for stage IIIA patients.

Adult↗
PubMed1989

Surgical transsternal treatment of bronchopleural fistula postpneumonectomy.

An original method of treatment for main bronchus fistula occurring after pneumonectomy was described in 1961. The operation is performed via a median sternotomy and the carinal region exposed. The main bronchi can then be divided in an area not involved with infection. We describe ten patients who underwent this procedure. The left bronchus was divided in seven patients and the right in three. Nine patients were long-term survivors, and one patient died in the early postoperative period from myocardial infarction. The transmediastinal approach for the control of bronchopleural fistula seems an effective means of managing this difficult postoperative problem.

Adult↗
PubMed1989

[Gynecomastia: our experience in surgical treatment].

A group of 78 patients with gynecomastia was observed between 1974-1987. Idiopathic gynecomastia was referred in 33 cases, cirrhosis in 31 cases, prostatic hypertrophy in 2 cases, while in 12 cases gynecomastia was induced by drugs. All patients with idiopathic form and 11 patients with secondary form were surgically treated by mastectomy (20 bilaterally and 24 unilaterally). The authors emphasize that, in this pathology, is much more important restoring the masculine feature of thorax without esthetic damage than removing the hypertrophic gland.

Adolescent↗
PubMed1987

[Surgical treatment of obesity].

Morbid obesity is a disease of modern society. Surgery is indicated when there is no endocrinopathy, medical treatment failed and Body Mass index (W/H2) is more than 40 (III degree obesity of Garrow). Many different methods were suggested in connection with the type of obesity, the associated diseases and the psychical state of the patient. Jejuno-ileal by-pass intend to produce a generic malabsorption syndrome. Personal experience is however good, possibly due to the blind loop jejunostomy that we always prepare as a conclusion of the operation and which gives an excellent support for the early post-operative time.

Adult↗