PubMed Health⌕ Search

Biomedical subjects

A Guarnieri

Publications and source records attributed to A Guarnieri.

At least 19 recordsLinked to original sources
PubMed2004

A novel biweekly multidrug regimen of gemcitabine, oxaliplatin, 5-fluorouracil (5-FU), and folinic acid (FA) in pretreated patients with advanced colorectal carcinoma.

Previous results suggest that GEM affects 5-fluorouracil (5-FU) metabolism and pharmacokinetics in cancer patients, while combined with oxaliplatin, levo-folinic acid, and 5-FU (GOLF regimen), at doses achievable in cancer patients, determines high cytotoxic and proapoptotic antitumour activity in colon cancer cells in vitro. On these bases we designed a phase I-II clinical trial testing the GOLF regimen in patients with metastatic colorectal carcinoma, who had received at least a prior line of chemotherapy. In total, 29 patients (20 males and nine females) enrolled in the study received every 2 weeks, gemcitabine (patients #1-3 received 600 mg m(-2); patients # 4-6 received 850 mg m(-2); while patients # 7-29 received 1000 mg m(-2)) on the day 1, levo-folinic acid (100 mg m(-2)) on the days 1 and 2; 5-fluorouracil (400 mg m(-2)) in bolus injection, followed by a 22-h continuous infusion (800 mg m(-2)) on the days 1 and 2, and oxaliplatin (85 mg m(-2)), 6 h after the 5-FU bolus on day 2. The most frequent side effect was grade I-II haematological toxicity. In total, 28 patients were evaluable for response: three achieved a complete response, nine a partial response, 10 had a stable disease, and six progressed. The average time to progression and overall survival of the patients was, respectively, 7.26 and 22 months. Our GOLF combination is well tolerated and seems promising for the treatment of advanced colorectal cancer.

Adult↗
PubMed2004

Gemcitabine (GEM), 5-fluorouracil (5-FU) and folinic acid (FA) in patients with different gastroenteric malignancies.

This phase II clinical trial was performed in order to evaluate the pharmacokinetics, toxicity and anti-tumor activity of a novel combination of gemcitabine (GEM), 5-fluorouracil (5-FU) and folinic acid (FA) designed on a specific translational basis. Every 4 weeks, 44 patients with various gastroenteric malignancies, 29 of whom had pancreas carcinoma, received a short intravenous (i.v.) infusion of FA (100 mg/m2) and 5-FU (400 mg/m2) on days 1-5, and GEM 1000 mg/m2 on days 1, 8 and 16. Our results suggest that, although this treatment leads to hematological and gastroenteric toxicity, it is very active in patients with pancreatic carcinoma. We therefore believe that an improved version would merit further investigation in larger scale trials.

Adenocarcinoma↗
PubMed2001

Prediction of lymph node status by analysis of prognostic factors and possible indications for elective axillary dissection in T1 breast cancers.

OBJECTIVE: To identify those patients with T1 breast cancers with lower risk of nodal metastases who can safely be spared axillary dissection. DESIGN: Retrospective study. SETTING: University hospital, Italy. SUBJECTS: Review of clinical records and histopathological slides of 547 patients with T1 breast cancer, operated on between 1984 and 1997. MAIN OUTCOME MEASURES: Incidence of axillary metastases in relation to age, menopausal status, diameter and grade of tumour, vascular invasion, DNA ploidy, S-phase fraction and hormone receptor state, by univariate and multivariate analysis. RESULTS: Axillary metastases were present in 159 patients (29%). On univariate analysis, diameter of tumour 10 mm or less (pT1a/pT1b cancers), no vascular invasion, and grade 1 tumour were significantly correlated with a lower risk of nodal metastases, but only vascular invasion (p = 0.0001, odds ratio = 3.1) and diameter of tumour (p = 0.04, odds ratio = 1.6) were independent predictors on multivariate analysis. Among 34 pT1a/pT1b cancers, with low grade of tumour and no vascular invasion, only 2 (6%) had axillary metastases. When only one favourable predictive factor was associated with diameter of tumour of 10 mm or less, the incidence of axillary metastases ranged from 12% for 43 patients with grade 1 cancers to 13% for 76 patients with no vascular invasion. CONCLUSIONS: Axillary dissection may be avoided in pT1a and pT1b breast cancers (< or = 10 mm), with low grade of tumour or no vascular invasion. T1 breast cancers 10 mm or less in diameter should be treated by a two-step approach, first wide excision of the tumour and then axillary dissection or not depending on pathological examination of the primary tumour.

Adult↗
PubMed2001

Initial experience with laparoscopic adjustable gastric banding and pouch dilatation: two cases.

BACKGROUND: Late proximal pouch dilatation (LPPD) has occurred occasionally following gastric banding for morbid obesity. At present, laparoscopic conservative resetting and oversuturing of the band is considered the standard procedure for pouch dilatation without any important posterior component. METHODS: Two cases of LPPD are presented, which occurred in our initial experience with the Lap-Band, corrected via a laparoscopic approach. RESULTS: The reintervention was necessary in both patients, with conservative laparoscopic repositioning and oversuturing of the band in the first case and laparoscopic substitution of the gastric band in the second. We have not observed further complications, and weight loss has been maintained in a midterm outcome in both cases (30 and 18 months follow-up). CONCLUSIONS: LPPD can be corrected with a conservative laparoscopic surgical approach, without complications and negative functional effects on mid-term outcome.

Adult↗
PubMed1999

Decay of the GRB 990123 optical afterglow: implications for the fireball model

Broad-band (ultraviolet to near-infrared) observations of the intense gamma ray burst GRB 990123 started approximately 8.5 hours after the event and continued until 18 February 1999. When combined with other data, in particular from the Robotic Telescope and Transient Source Experiment (ROTSE) and the Hubble Space Telescope (HST), evidence emerges for a smoothly declining light curve, suggesting some color dependence that could be related to a cooling break passing the ultraviolet-optical band at about 1 day after the high-energy event. The steeper decline rate seen after 1.5 to 2 days may be evidence for a collimated jet pointing toward the observer.

Journal Article↗
PubMed1998

Photometry and spectroscopy of the GRB 970508 optical counterpart

An optical transient within the error box of the gamma ray burst GRB 970508 was imaged 4 hours after the event. It displayed a strong ultraviolet excess, and reached maximum brightness 2 days later. The optical spectra did not show any emission lines, and no variations on time scales of minutes were observed for 1 hour during the decline phase. According to the fireball and afterglow models, the intensity should rise monotonically before the observed optical maximum, but the data indicate that another physical mechanism may be responsible for the constant phase seen during the first hours after the burst.

Journal Article↗
PubMed1998

The Millimeter-Wave Spectrum of DCCNC

The millimeter-wave spectrum of deuteroethynylisocyanide has been observed and analyzed in the ground and in the first excited vibrational states (v4, v5, v6, v7) = (0100), (0010), and (0001). Rotational, centrifugal distortion, and l-type doubling constants are given. Copyright 1998 Academic Press.

Journal Article↗
PubMed1997

[Original procedure of functional plasty of primary inguinal hernias].

We describe a novel autoplasty method we developed for primary inguinal hernia repair and report our results in nearly 150 operations. The method is based on novel principles: priority given to an individual stato-dynamic conception of the inguinal region; effect on physiological defense mechanisms of the inguinal canal; absence of tension on the sutures by autoplastic repair.

Hernia, Inguinal↗
PubMed1996

[A case of pancreatic somatostatinoma].

The authors describe a case of somatostatinoma localized in the body and tail of the pancreas. They emphasize the rarity of this finding (only 33 cases with certain pancreatic localization are reported in literature) and the absence of a distinctive syndrome, which could direct to an early diagnosis, the authors are in doubt about the real incidence of this disease. The absence, generally, of a distinctive syndrome, the poor condition of these patient and then the lack of surgical treatment and histological examination, could lead to a lower valuation. Delayed diagnosis and then the local extension of this neoplasm often make surgical treatment vain. Nevertheless since somatostatinoma has more possibilities of radical resection than pancreatic cancer, it's required to know its features and course so to increase possibilities of an early diagnosis. In fact disregarding surgical treatment, the survival of these patients, one year after diagnosis, is about 48%. This result is better than the survival of patients with pancreatic or biliary duct cancers. Current diagnostic procedures are reported.

Adult↗
PubMed1995

Nonsteroidal antiinflammatory agents. XXIII. Synthesis and activity of stereomeric (+/-)-erythro- and (+/-)-threo-2-(4-biphenylyl)-3-hydroxy-2-methyl-3-phenyl-propionic acids.

In pursuing our research on the NSAIDs, the diastereomeric (+/-)-erythro- and (+/-)-threo-2-(4-biphenylyl)-3-hydroxy-2-methyl-3-phenyl-propionic acids (4 and 5) were synthesized; the last was also resolved in its optical isomers (6 and 7). The attribution of the relative configuration to 4 and 5 was performed by means of X-ray analysis. The compounds were tested for their antiinflammatory activity. The acid 4, which resulted very interesting, was tested also for analgesic and antipyretic activity, as well as for behavioural effects, gastric tolerability and acute toxicity. On the basis of the obtained data, this compound resulted a very promising one.

Animals↗
PubMed1995

[Cervical esophageal perforation caused by a foreign body: a clinical case].

The Authors report a case of cervical esophageal perforation from foreign body. Comparing their experience with data from literature, they point out the diagnostic importance of both X-ray studies, in order to demonstrate the site of the lesion, and CT scans, to have accurate information on perilesional infective complications (abscesses). Early surgical treatment, with primary closure of perforation and adequate drainage, associated with antibiotics and enteral or total parenteral nutrition, allows good results in most cases.

Aged↗
PubMed1995

Acid-base balance determination on ultrafiltrate in two-chamber technique hemodiafiltration (PFD).

Correction of the acid-base balance in uremic patients during hemodiafiltration (HFD) may be biased by an inadequate monitoring of pH and blood gases. HDF performed with the two-chamber technique (PFD) generates pure ultrafiltrate (uf) unmixed with dialysate. We carried out 84 determinations of HCO3- levels in 15 different PFD patients by measuring the pH and pCO2 of the uf, then correlated the values with those simultaneously evaluated on arterial blood with standard methods. The mean HCO3- levels (mmol/L) were 23.21 +/- 2.49 in blood samples and 25.54 +/- 3.07 in uf, with a mean difference of -2.33 +/- 1.46. Statistical analysis gave: t = 13.5 (p = O) (one-sample analysis), r = 0.86 (p = 0) (linear regression analysis) and a good agreement between the two clinical measurements (81 out of 84 data points fell within the 95% confidence interval) (Bland-Altman analysis). In conclusion, we suggest that during HDF performed with the two-chamber technique, the patient's HCO3- level can be monitored on the uf without blood sampling.

Acetates↗
PubMed1994

Combination chemotherapy with epirubicin and mitomycin C as first-line treatment in advanced breast cancer.

From December 1988 to February 1991, 112 consecutive patients were submitted to epirubicin + mitomycin C chemotherapy as first-line treatment for advanced breast cancer. Epirubicin (75 mg/m2) was given every 3 weeks and mitomycin C (10 mg/m2) every 6 weeks. Only patients with visceral involvement or with a disease-free interval of less than 12 months were considered eligible. 102 patients were evaluated for response and toxicity in the present analysis. The main sites of involvement were viscera, soft tissues, bone in 71 (69.6%), 19 (18.6%) and 12 (11.8%) patients, respectively. Multiple site involvement was present in 66 (64.7%) cases. A total of 726 courses of therapy were administered (range 2-14; mean 7.2). Follow-up ranged from 96 to 210 weeks (median follow-up 138 weeks). Response rate was complete response (CR): 21.6% [95% confidence interval (CI) +/- 0.8], partial response (PR) 49.0% (95% CI +/- 0.1), stable disease (SD) 12.7% (95% CI +/- 0.1), progressive disease (PD) 16.7% (95% CI +/- 0.1), CR + PR: 70.6% (95% CI +/- 0.1). Median values of survival and time to progression were 79.4 and 42 weeks, respectively. At 2 years, 37.2 +/- 4.7% and 12.8 +/- 3.3% of the patients, respectively, were alive or without evidence of progression. Toxicity was generally mild. One hundred and four (14.3%) cycles in 53 patients were delayed due to haematological (82) or cardiac (3) toxicity, infectious disease (11) or causes not related to the treatment (8).

Adult↗
PubMed1994

Inhaled mycotoxins lead to acute renal failure.

Mysterious deaths of archeologists after opening Egyptian tombs have been suspected, but never proved, to be secondary to inhalation of mycotoxin. We observed a case of acute renal failure (ARF) due to inhalation of ochratoxin A produced by a mould of the species Aspergillus ochraceus. After working 8 h in a granary closed for several months, a farmer and his wife suffered respiratory distress; the woman developed non-oliguric ARF and biopsy revealed tubulonecrosis. A strain of Aspergillus ochraceus producing ochratoxin was isolated from the wheat.

Acute Kidney Injury↗
PubMed1994

[New surgical technique for the repair of abdominal hernia with mesh].

The use of prostheses is indispensable in major anterior abdominal hernias when it is not possible to close the edges of the hernial opening without strain. The most commonly used prostheses are made from dacron, polypropylene (PPNE) and expanded polytetrafluoroethylene (EPTF) mesh. It is important to point out that, in spite of the excellent characteristics of these materials, there is no ideal prosthesis. There is a well-known increase in the risk of rejection and infection when mesh is placed in contact with the subcutis and the formation of adhesions, with the possibility of occlusions and fistulas, when it is in direct contact with the intestine. Whereas EPTF does not cause problems of adhesion, it has a greater tendency to cause rejection and infection if placed in the subcutaneous area. Moreover, there is a increased risk of displacement and it is also very costly. The opposite is true of dacron and PPNE mesh. When the mesh serves to "replace" a wall defect and it cannot be isolated by the interposition of the peritoneum or muscular fascia, it comes into direct contact with the intestine and subcutaneous tissue. The technique outlined here aims to isolate the prosthesis from the intestinal loops and subcutaneous tissue. The hernial sac itself is used for this purpose and is divided into two flaps by a cut perpendicular to the wall. The free edge of one flap is sutured to the inside of the hernial opening. The mesh is then sutured half inside and half outside the hernial opening.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Acute renal failure from inhalation of mycotoxins.

Mysterious deaths of archeologists after opening Egyptian tombs have been suspected to be secondary to inhalation of mycotoxin, however, the hypothesis has never been verified. Recently, we observed a case of acute renal failure (ARF) undeniably due to inhalation of ochratoxin of Aspergillus ochraceus. After spending 8 h in a granary which had been closed for several months, a farmer and his wife suffered temporary respiratory distress; 24 h later, the woman developed nonoliguric ARF and biopsy revealed tubulonecrosis which healed in 24 days. Toxic substances were not found, but a strain of A. ochraceus producing ochratoxin was isolated from the wheat.

Acute Kidney Injury↗
PubMed1992

A new technique for indirect inguinal hernia repair.

This report concerns a preliminary study of a new technique for indirect herniorraphy, which was used in 242 patients from December 1988 through March 1991. Its main characteristics are the creation of a deep neo-inguinal ring in a more medial site, shortening of the inguinal canal by transposition of the superficial ring to the point where the inferior border of the internal oblique muscle is well represented, reinforcement of the inguinal canal by overlapping the external oblique aponeurosis in a double-breast fashion, and maintenance of the cremasteric muscle. Follow-up in our outpatient clinic was carried out at 1, 6, 12, and 24 months in 71% of our patients. There were no recurrences, except for one crural pseudo-recurrence, no mortality, and no testicular atrophy. Thirteen percent of patients had subcutaneous serous collection; 1% had hematomas; 2% temporary testicular edema; and 0.4% wound infection.

Abdominal Muscles↗