Biomedical subjects
Publications and source records attributed to A Andreani.
The synthesis of three series of new imidazo [2,1-b] thiazoles (nitriles 1-7, amides 8-14 and p-sulfamidophenylhydrazones 15-24) is reported. Among the compounds tested, only 12 showed a borderline diuretic activity. Compounds 15-24, possible prodrugs of sulfanilamide, were devoid of antibacterial activity.
The synthesis of two series of 1-(N-methylanilinoethyl)indoles is reported. The first arises from the N-alkylation of indole-3-acetic acid or its methylester, while the second was prepared by means of the Witting reaction on the appropriate aldehyde. The compounds were tested in mice (hot plate test and phenyl-p-benzoquinone induced writhing test) for their analgesic activity. None of the compounds was significantly active in the hot plate test. However, N-methylanilinoethyl 1-(N-methylanilinoethyl)-3-indolylacetate (7) was the most active one in the phenyl-p-benzoquinone induced writhing test, which indicates that 7 has a peripheral analgesic effect.
1-Phenylalkylindole-3-carboxylic acids 1-4, indole-1-acetic acids/esters 5-10 and the hydrazones 11-15 were prepared and submitted to the rat paw edema test using carrageenin. In the first two groups of compounds, the 2-chloro indoles were more active than the corresponding indole derivatives. In the third group the activity seemed to be determined largely by the substituent at the 1-position.
New indole derivatives and their intermediates were tested as cytotoxic agents on a culture of P388 leukemia cells. The aldehyde 2a was more active than the thiosemicarbazones 3a, b and the nitrosourea 14. The chloroacetyl derivatives 10, 11 were the most potent cytotoxic agents.
Six cases of familial basal cell nevus syndrome encountered over the past 20 years are described. The syndrome is fairly rare and its importance derives from the fact that it is associated with skin lesions of the basal cell epithelioma type that are often highly invasive as well as dysontogenic lesions affecting many organs and systems (mandibular cysts, skeletal anomalies, cerebral calcifications, etc.). On the basis of personal experience and in view of the essentially constant evolution of individual lesions into invasive forms (that were certainly the direct cause of death in two of the six patients), early treatment is considered to be of prophylactic significance. The best treatment is thought to be diathermocoagulation rather than traditional surgery radiation treatment.
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The synthesis of two nitrogen mustard derivatives (VIII and IX) related to the well-known local anesthetic ketocaine (III) is reported. These compounds were tested in mice implanted with Ehrlich ascites tumor cells, and the antitumor activity was compared with that of two previously synthesized analogues (I and II) lacking the nitro group and with that of doxorubicin. The monofunctional compound IX was inactive, but the bifunctional compound VIII showed potent antitumor activity (%T/C greater than 254 at 20 mg/kg).
The strategy of high-dose intramuscular haloperidol as routinely applied in a general hospital psychiatric ward to 74 successive patients, 33 of whom stayed only up to seven days, and a further 34 up to 15 days, led to a complete recovery in only six, and complete lack of change in 23. Adverse reactions were recorded in 42, severe enough to stop treatment in eight; there were three deaths. In view of this risk-benefit analysis, systematic application of this high dose strategy to get a more rapid turnover of patients is unjustified.
Diagnostic procedure, therapeutic care and degree of follow-up delivered to 1692 lung cancer patients over 2 years (1978-79) in 31 Italian hospitals were reviewed. The data show marked deficiencies in the various indicators analysed: staging by standard methods was recorded only in 13% of patients; reliable histocytologic classification in 54% of patients. A group of commonly accepted protocols was adopted as first-line therapy only in 49% of treated cases; 19% of patients were regularly followed according to standard programs, whereas 49% had been dropped without any information in the charts. Better performance, although not satisfactory, was found in hospitals with oncologic facilities and wards compared to centers without "ad hoc" organizations. The discussion focussed on the limits of organizational measures and efforts to determine widespread improvement in care for a disease such as lung cancer for which real therapeutic gains are still hard to achieve.
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The reaction between o-hydroxybutyrophenone and tris(2-chloroethyl)amine gave two analogues (II, V) of the well-known local anesthetic ketocaine (I). Compounds II and V showed interesting antitumor activity in mice implanted with Ehrlich ascites tumor cells (% T/C = 149 at 5 mg/kg and 171 at 50 mg/kg, respectively). Further studies on the pharmacological behavior of these new compounds are in progress.
A large sample of cancer patients was reviewed over a two-year period (1978-1979) in 31 general and community hospitals representing five Italian regions, differing in terms of health care organization. Two thousand four hundred and six patients had breast cancer, 1692 lung cancer, 303 non-Hodgkin's lymphomas, 277 ovarian cancer and 235 Hodgkin's lymphoma. Relevant information was collected from medical records through specific pre-standardized and tested forms. The paper discusses the results obtained with respect to (a) general descriptive data of the population; (b) completeness and reliability of recorded data (e.g. staging, histological classification, therapy); and (c) accuracy and completeness of the follow-up. Consistency of the information obtained on selected items with published series of patients suggests that this methodology is worth a wider testing as a simple, inexpensive tool for routinely monitoring the care of cancer patients and the impact on it of organizational and educational interventions.
The diagnostic and therapeutic care and degree of follow-up delivered to 2406 breast-cancer patients over two years (1978-79) in 31 Italian hospitals are reviewed. Although there was broad agreement about recommended treatment protocols, staging by standard methods was recorded in only 44% of patients, assessment and reporting of side-effects was considered in only 49% of all treated patients, follow-up data at two years were available for only 54% of living patients, and the dropout rate from chemotherapy protocols was 35%. Improvement of these unsatisfactory aspects of care would allow a better appreciation of the real benefit that could be achieved with recommended protocols and would result in a more effective use of health resources.
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