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Biomedical subjects

A Distefano

Publications and source records attributed to A Distefano.

At least 19 recordsLinked to original sources
PubMed2001

[Computer planning for postmastectomy breast reconstruction by tissue expansion].

Aim of this paper is to present a computer program able to provide objective and quantitative data useful to guarantee the selection of the proper implant in order to obtain symmetry with the contralateral breast, in case of unilateral breast reconstruction by tissue expansion, especially for surgeons without experience or for occasional operators. Our C++ program provides the final implant volume using the measurements of the semi-circumference and projection of the contralateral breast performed on the supine patient. The aim is the symmetry of the two breasts. According to personal experience in breast reconstruction by tissue expanders, this program allows non invasive and simple measurements of the breast volume, useful to obtain the mammary symmetry. In case of breast reconstruction by tissue expansion, the preoperative evaluation is usually based on the surgeon experience and on the empirical observation without knowing the correct volume to reach. Since this program is useful to know the precise necessary volume for breast reconstruction, it allows the surgeon to obtain a better plastic result.

Breast Implants↗
PubMed2001

[Computer-aided preoperative planning of tissue expansion].

OBJECT: The aim of this paper is to introduce a computer program developed to provide objective and quantitative data useful to provide proper expander selection when a rectangular tissue expander has to be used. METHODS: The program has been developed to calculate the volume of a rectangular tissue expander to obtain the exact amount of yield necessary to allow for reconstruction of a determined defect. The only data to be supplied are the length and the width of the defect to be reconstructed. RESULTS: The accuracy of the results obtained by the computer program was tested clinically comparing preoperative data with volume measurements obtained at the end of the expansion procedure. In our study the resulting data did not show any statistically significant difference (p<0,05) between the two groups. CONCLUSIONS: In our opinion, although its use is not aimed at replacing clinical judgment based on experience and careful observation, this program may be considered a simple and useful adjunct for the inexperienced surgeon (or the occasional operator) planning to use a rectangular tissue expander.

Humans↗
PubMed2000

Multiple coronary artery aneurysms in a child with neurofibromatosis type 1.

UNLABELLED: A number of frequently unrecognised vascular manifestations have been described in patients with neurofibromatosis type 1 (NF1), including involvement of the great vessels, cerebral, visceral and renal arteries. Rarely, changes in the coronary arteries have been reported in adults with NF1. We report on a 16-year-old boy affected by NF1 with dysmorphic features and three aneurysms in the mid-portion of the left descending coronary artery disclosed by chance during investigation for a malignant peripheral nerve sheath tumour. Molecular analysis detected a gross de novo deletion in the NF1 gene. The boy had had no previous cardiac symptoms but died suddenly after developing signs and symptoms suggestive of myocardial infarction. CONCLUSION: To the best of our knowledge, this represents the first report of multiple lesions in the coronary arteries in a child affected by neurofibromatosis type 1 with a known deletion of the neurofibromatosis type 1 gene.

Abnormalities, Multiple↗
PubMed1996

Megacalycosis on duplex system upper moiety.

The authors report a rare case of megacalycosis located on a duplex system upper moiety, and analyse the problems related to its pathology, etiopathogenesis, clinical manifestations and diagnosis.

Dilatation, Pathologic↗
PubMed1988

Enhancement of mixed lymphocyte culture reactions between donor and recipient in B cell chronic leukemia using antibody-coated beads.

Matching of donors and recipients in cases of B cell chronic lymphocytic leukemia (CLL) is complicated by the fact that the cancer clone dominates the blood. A case of CLL was characterized for its antigenic phenotype using monoclonal antibodies. Iron beads were coated with the appropriate antibody and used to remove the cancer clone. A mixed lymphocyte culture (MLC) utilizing the purified cells as well as unpurified cells and sheep cell rosetted purified cells was performed with the donor. Using coated beads, the T cell population rose from 8% to 95% in one treatment versus 8% to 42% with sheep cells. MLC data were statistically better with bead-treated cells, and the results demonstrated the importance of this technique for transplantation matching.

Antibodies↗
PubMed1988

The utilization of monoclonal antibodies in the diagnosis of unusual leukemias.

Development of monoclonal antibodies to lymphoid cells has allowed for simple methods for the classification of leukemias. Using the monoclonal antibodies, B1, B4, T1, T11, Ia, CALLA, My7, My9, and a polyclonal TdT reagent, we report a number of unusual phenotypes analyzed by flow cytometry. Two cases of mixed linkage leukemia are reported, one marked with anti-CALLA and My9, the other marked with T11 and Ia. Three rare cases of pediatric CLL are reported. Both were of B cell origin with chromosome transformation. These studies demonstrate the clinical importance of monoclonal antibodies in leukemia classification. The results also show that the so-called rare leukemias may not be as rare as previously thought.

Adolescent↗
PubMed1984

Adriamycin, dibromodulcitol, and mitomycin combination chemotherapy for patients with metastatic breast carcinoma previously treated with cyclophosphamide, methotrexate, 5-fluorouracil, vincristine, and prednisone.

Twenty-six evaluable patients with metastatic breast carcinoma previously treated with a combination of cyclophosphamide, methotrexate, 5-fluorouracil, vincristine, and prednisone (CMFVP) were treated with a combination of doxorubicin (Adriamycin), dibromodulcitol, and mitomycin (ADM). Four patients (15%) achieved complete remission, and 10 patients (39%) had a partial response. Five patients (19%) had stable disease, and seven patients (27%) experienced disease progression. The median time to disease progression was 10 months for responding patients (range, 4-44 months) and 5 months (range, 2-13 months) for patients with stable disease. The median survival duration was 15 months (range, 6-44+ months) for responders, 11 months (range, 2-27 months) for patients with stable disease, and 4 months (range, 2-41 months) for nonresponders. Two of the four patients with complete remission are alive and in continued remission at a follow-up of 44 and 40 months. Seventy-one patients with greater than or equal to two sites of metastasis responded, whereas 23% of patients with greater than or equal to three metastatic sites responded. Although higher responses were seen with soft tissue and osseous metastasis, responses were observed in all three sites of metastasis. This combination chemotherapy regimen with ADM is an effective second-line program for patients who have previously received CMFVP chemotherapy.

Adult↗
PubMed1981

Management of breast cancer patients failing adjuvant chemotherapy with adriamycin-containing regimens.

Sixty-two patients with breast cancer treated with Adriamycin-containing adjuvant chemotherapy developed recurrent disease. Four patients refused to take any form of systemic therapy at the time of relapse. Fifty-eight patients were managed with various treatment modalities, and of these 33 (57%) achieved on objective remission, 11 (19%) had stable disease and 14 patients (24%) did not respond to any form of therapy. Twenty-four patients received more than one treatment modality. Thirty-eight patients were treated with chemotherapy and 35 received endocrine therapy. Eight of 20 patients (40%) achieved objective remission upon retreatment with higher dose of 5-fluorouracil, Adriamycin, and cyclophosphamide at time of relapse, and seven of 18 patients (38%) treated with other chemotherapeutic agents showed objective remission. Fourteen of 35 patients (40%) achieved objective remission with hormonal therapies. The median survival from first relapse was 15 months for all patients, and was 25.7 months for responding patients. Survival was significantly longer in asymptomatic patients compared with those who were symptomatic from recurrent disease.

Adult↗
PubMedDate not supplied

The leisure time and the third age: the experience of a geriatric day hospital.

Leisure time represents an important part of the so-called 'successful aging' and contributes to overcome the problems related to the reduction of the social roles, favoring a better subjective adaptation to old age. In this work we observed the elderly population frequenting our Day Hospital, by estimating the affective sphere (geriatric depression scale, GDS), the autosufficiency (activity of daily living, ADL; and instrumental activity of daily living, IADL) and the schooling years in correlation with the type and length of leisure time activities during the day. These data have been compared with those of the national statistics (ISTAT). The analyses revealed a very wide diffusion of the utilization of mass media and a large interindividual differentiation of the modes of using leisure time. The correlations between the indices of affectivity and autosufficiency show an effect on the types of leisure time activities, while the scholarity of the subjects has no influence on it. These results suggest considering leisure time as an indispensable part of the relational life of elderly subjects, having an important 'valency' for the affective sphere and the individual expectations and needs.

Journal Article↗
PubMedDate not supplied

Suicides and the third age.

The phenomenon of suicide represents a complex problem, the specific aspects of which should be examined by a multifactorial analysis, particularly in the elderly subjects. Although the research on risk factors continues to grow, only a limited knowledge is available on the biological changes increasing the risk for suicide. Similarly, limited information is at our disposal about the contributing psychosocial processes extending beyond the demographic factors. Although the best explored population is the elderly using primary care services, no proven interventions are known for the time being, although some efforts to test certain approaches reaching these older adults are under way. Apparently even more, continued efforts are needed to change the attitudes toward the mental illnesses and their treatments in general, in order to reach the older adults who are still outside of the health care services.

Aged↗
PubMedDate not supplied

Echocardiographic studies on elderly patients with white coat hypertension to evaluate cardiac organ damages.

This case-control study was aimed at evaluating the distribution of some echocardiographic signs of cardiac organ damages in elderly patients with white coat hypertension (WCH), as compared with a normotensive group of elderly. Correlations between the signs of cardiac organ damages and the clinical and ambulatory blood pressure parameters (obtained by means of a 24-h monitoring) have also been evaluated. The first screening covered 258 elderly subjects of both sexes, aged from 65 to 82 years, with clinical diagnosis of hypertension (systolic and diastolic blood pressures being higher than 160 and 95 mmHg, respectively). Of this group, 116 subjects remained in the final pool, and their echocardiographic parameters were compared with 33 normotensive (N) subjects. Out of the 116 clinically hypertensive patients, 29 (25%) displayed WCH, according to the established criteria. Variance analyses on the ranks followed by Dunn's test revealed no statistically significant differences between the N and WCH groups, while the hypertensive group (H) proved to be significantly different from both the N and the WCH groups. In addition to the descriptive statistics, an analysis of correlations between the pressure variables and the echocardiographic parameters has also been performed by means of a forward-stepwise multiple linear regression method. The models generated by this regression analysis covered only the ambulatory diurnal systolic pressure, and the clinical diastolic pressure in most of the cases of the echocardiographic parameters, taken as independent variables. In all these cases, the standardizecl correlation coefficient of the diurnal systolic pressure was always higher than that of the clinical diastolic pressure, indicating that the echocardiographic parameters depend more strongly on the first than on the second pressure value.

Journal Article↗
PubMedDate not supplied

On the importance of multidimensional evaluation of elderly oncologic patients.

The role of comorbidity and the psycho-affective attitudes have been studied in 108 elderly oncological patients, in comparison with 25 elderly subjects without tumor pathologies. The results have revealed positive correlations between the activity of daily living (ADL), as well as the instrumental activity of daily living (IADL) scales and the comorbidity both in the oncological subjects and the controls. The performance status defined by the eastern cooperative oncology group (ECOG-PS) positively correlated with the parameters of ADL and IADL scales, demonstrating an increased vulnerability and fragility of the oncological patients in their everyday activities. An increased psychological fragility of the oncological patients has also been revealed by the scores of the geriatric depression scale (GDS), which might be cause and consequence at the same time of the disease itself. In addition, the polypathologies are not associated with an increased gravity of the tumor stage, although there have been 2.5 accompanying pathologies, mainly diseases of osteoarticular and cardial character. The correction of functional damages of various organs due to aging or concomitant or previous diseases is a period of fundamental importance for an adequate oncological therapy. The principal goal of any intervention in the elderly oncological patient should certainly be an improvement of the quality of life, including an alleviation of the impact of the diagnostic and therapeutic procedures on it.

Journal Article↗
PubMedDate not supplied

[Exanthematous outbreak caused by human parvovirus B19 in a school in Banderaló, Argentina].

We report an exanthematic outbreak in a school of Banderaló town, located in the district of General Villegas, Buenos Aires province, Argentina. This outbreak affected 21 individuals, with a wide range of age (out of a total population of 1400). The observed clinical manifestations were exanthema and in some cases fever, asthenia, arthropathies and myalgia. The presence of specific IgM antibodies against measles, rubella and human parvovirus B19 were investigated. Analysis of IgM antibodies to parvovirus B19 by ELISA was positive in 90.8% of the cases and viremia was detected in 66.7% of the patients by nested PCR. These results indicate that human parvovirus B19 was the etiologic agent of the outbreak and they confirm its circulation in Argentina. Moreover, this study demonstrates that PCR may be useful for the study of transmission foci and of individuals with prolongued clinical manifestations. We consider that it is necessary to include the differential diagnosis of human parvovirus B19 in the surveillance of exanthematic virosis.

Adolescent↗