Biomedical subjects

A Larocca

Publications and source records attributed to A Larocca.

10 recordsLinked to original sources

PubMed2006

Prognostic factors for non-Hodgkin's lymphoma patients treated with chemotherapy may not predict outcome in patients treated with rituximab.

Several factors predict outcome for patients with non-Hodgkin's lymphoma (NHL) after chemotherapy. However, predictors of response to rituximab have not been identified. Baseline characteristics for 166 NHL patients (130 follicular) in a phase III trial of rituximab were analysed by univariate and multivariate methods to determine whether any of 27 factors predict response and/or response duration. In a univariate analysis, response to rituximab was associated with follicular histology, no prior fludarabine therapy, prior autologous bone marrow transplantation (ABMT), lack of bone marrow involvement or extranodal disease, positive bcl-2 in blood, and fewer relapses. By univariate analysis, longer median time to progression (TTP) and/or duration of response (DR) after rituximab therapy was associated with International Prognostic Index lower-risk group, multiagent chemotherapy, and low/normal serum lactate dehydrogenase (LDH) or beta2 microglobulin. In the multivariate analysis, response to rituximab correlated with follicular histology, prior ABMT, multiagent chemotherapy, and no bone marrow involvement; longer TTP and/or DR correlated with low/normal serum LDH or beta2 microglobulin, high CD3+ cells, and response to last chemotherapy. The follicular lymphoma international prognostic index (FLIPI) did not correlate consistently with response to rituximab or response duration. Several factors associated with prognosis following chemotherapy did not correlate with response to rituximab or response duration. NHL patients can respond to rituximab despite having factors associated with a poor outcome to chemotherapy.

Antibodies, Monoclonal↗

PubMed2003

Gallbladder cholesterol polyps and cholesterolosis.

Cholesterolosis of the gallbladder consists in an accumulation of cholesterol esters and triglycerides in the macrophages at gallbladder wall level and may be either diffuse or polypoid in form. A prevalence of 4-8% has been reported, particularly in the male sex; results concerning a relationship between cholesterolosis and lifestyle are controversial (alcohol intake, smoking habit), as well as the clinical and laboratory parameters, such as serum cholesterol and body mass index. Even more controversial is the relationship with gallstones which has been associated with the presence of cholesterol polyps only in a few surgical series. An increase in the activity of the cholesterol ester enzyme has been observed, in cholesterolosis patients, at gallbladder mucosa level which has led to the hypothesis of an increase in cholesterol ester deposit at this level; the hypothesis of an alteration in bile composition, in these patients, still remains to be elucidated. Ultrasonography is a sensitive tool in the diagnosis of cholesterolosis even if the use of echoendoscopy is becoming increasingly important in the differential diagnosis between benign and malignant polypoid lesions. Even if, in a few series, patients with polyps present a clinical pattern characterized by specific biliary symptoms, both in our experience and in that of others, symptoms are aspecific, the frequency of dyspeptic symptoms being comparable to that in the general population. The natural history of this lesion is, in general, benign and for polyps with size ranging from 6 mm to 10 mm a yearly follow-up with ultrasonography is advisable.

Journal Article↗

PubMed2000

Standards for diagnosis of gastrointestinal motility disorders. Section: ultrasonography. A position statement from the Gruppo Italiano di Studio Motilità Apparato Digerente.

Ultrasonography is a non-invasive, relatively easy, validated and reproducible technique. We assessed the usefulness of functional ultrasonography to study disorders of gastro-oesophageal tract, gallbladder and pancreatic duct. Oesophagus Oesophagus and the gastro-oesophageal junction can be visualized in children up to 5 years old. Ultrasonography shows 100% sensitivity and 87.5% specificity compared to ambulatory pH-metry for gastro-oesophageal reflux disease diagnosis. Stomach Ultrasonography can be used to estimate whole gastric volume, antral area or diameters, antro-pyloric volume, transpyloric flow in fasting state and in response to test meal. Gallbladder Ultrasonography is reliable to estimate volume in fasting state and in response to test meal or exogenous stimulus. For both stomach and gallbladder, indications might include the study of healthy subjects and of pathophysiologically relevant conditions such as dysmotility-like dyspepsia, suspicion of delayed gastric emptying, diabetes mellitus, gallstone disease and effect of drugs either delaying or accelerating motility. Common bile duct Ultrasonography can be used to estimate interprandial and postprandial common bile duct diameter in patients with clinical suspicion of common bile duct obstruction in fasting state and in response to test meal or exogenous stimuli. Although functional ultrasonography is used mainly for research purposes, its simplicity makes it appealing for clinical use to assess gastrointestinal motility in health and disease.

Gastrointestinal Diseases↗

PubMed2000

Review: low caloric intake and gall-bladder motor function.

Cholelithiasis is the primary expression of obesity in the hepatobiliary system. In obese subjects the risk of developing gallstones is increased due to a higher cholesterol saturation of gall-bladder bile. During weight reduction with very low calorie diets (VLCD) the incidence of gallstones increases, but the mechanism for gallstone formation is not completely understood and several pathogenetic mechanisms have been suggested: increased saturation of bile, increased gall-bladder secretion of mucin and calcium, increased presence of prostaglandins and arachidonic acid. Alterations in gall-bladder motility may contribute to gallstone formation, but few studies have addressed the issue of gall-bladder motility during rapid weight loss and its possible role in gallstone formation. VLCD have been associated with a gall-bladder stasis, as a consequence of reduced gall-bladder stimulation by low fat content of the diets. A threshold quantity of fat (10 g) has been documented to obtain efficient gall-bladder emptying. Ursodeoxycholic acid administered during VLCD seems to have a protective role in developing a biliary cholesterol crystals. Gall-bladder emptying was lower in response to low fat meals with respect to relative higher fat meals, before as well as during the VLCD. This may account the possibility of an adaptative response of the gall-bladder motility to a given diet regimen. Adequate fat content of the VLCD may prevent gallstone formation, maintaining adequate gall-bladder motility and may be more economic and physiologically acceptable than administration of a pharmacological agent.

Bile Acids and Salts↗

PubMed1999

Anti-CD20 monoclonal antibodies as novel treatments for non-Hodgkin's lymphoma.

Anti-CD20 monoclonal antibodies (MAbs) offer new options for patients with non-Hodgkin's lymphoma, needed because existing therapies have many limitations. The unconjugated, chimeric anti-CD20 antibody, Rituximab (MabThera(R), Rituxan(R)), has recently been approved in the USA for patients with relapsed or refractory, low-grade or follicular, B-cell non-Hodgkin's lymphoma, and in Europe for therapy of relapsed stage III/IV follicular lymphoma. In the pivotal study of Rituximab, an overall response rate of 50% was achieved with median time to progression in responders of 13.2 months. Studies are ongoing with the 90Y-labelled murine anti-CD20 antibody, IDEC-Y2B8. The response rate in a Phase I/II study in low-grade and intermediate-grade patients was 67%.

Journal Article↗

PubMed1998

Ultrasound-guided core-needle biopsy is effective in the initial diagnosis of lymphoma patients.

BACKGROUND AND OBJECTIVE: With the development and refinement of new guidance methods for percutaneous biopsies, many investigators have reported studies supporting a role for radiologically guided core-needle biopsy in the diagnosis of malignant lymphoma under certain clinical circumstances. The aims of this report are to evaluate the efficacy of findings at ultrasound (US)-guided core-needle biopsy of abdominal lymphoma on patient care and define the key determinants of clinical success. DESIGN AND METHODS: US-guided core needle biopsies were performed in 55 patients with abdominal lymphoma: 44 non-Hodgkin's lymphoma (NHL) and 11 Hodgkin's disease (HD); 41 had had no prior lymphoma and 14 had previously diagnosed lymphoma. All the biopsies were performed under US control using a 21-gauge modified Menghini needle. Overall, 53/55 (96%) patients were treated on the basis of biopsy findings only, including 14/14 (100%) patients with a history of lymphoma and 39/41 (93%) patients with no such history. RESULTS: In 46/53 (87%) patients it was possible to assess the specific histotype. No differences between the diagnostic rates of HD and high grade-NHL were recorded. There were no complications related to the biopsies. INTERPRETATION AND CONCLUSIONS: Our data indicate that abdominal US-guided core-needle biopsy should be considered as an effective and safe procedure in the diagnosis of patients with lymphoma offering the possibility of determining the tumor subtype and the subsequent specific treatment.

Abdominal Neoplasms↗

PubMed1997

In vitro antimicrobial properties of azidothymidine (AZT).

In addition to the activity against a number of retroviruses, azidothymidine (AZT) has antibacterial activity against many bacteria. The effect of AZT on 224 bacterial species, including 25 strains of Salmonella spp. isolated from HIV-positive patients, was tested. AZT had no activity against all the strains of tested Gram-positive bacteria and Pseudomonas species (MIC > 128 micrograms/ml), whereas a different activity against Enterobacteriaceae (MIC range, 128 to 0.06 micrograms/ml) was found. In particular 76% of Salmonella spp. isolated from HIV-positive patients showed MICs > 1 microgram/ml, whereas similar MICs value were found in 50% of the Salmonella strains isolated from HIV-negative subjects. In addition, strains of Salmonella isolated from stools were more resistant to AZT when compared to strains isolated from blood even if this difference was not statistically significant. No correlation was found between length of therapy and Salmonella resistance to AZT in HIV-positive patients and a low incidence of Salmonella relapses in subjects treated with AZT was observed. The possibility that AZT may have an ancillary benefit in controlling some bacterial infections in AIDS patients is discussed.

Acquired Immunodeficiency Syndrome↗

PubMed1993

Salivary effects on polymorphonuclear leukocyte functions.

Respiratory burst, enzymatic degranulation and bacterial killing were investigated on peripheral blood polymorphonuclear leukocytes (polymorphonuclear leukocytes) incubated with a pool of salivary fluids elicited from healthy donors. Low saliva concentrations primed polymorphonuclear leukocytes for enhancement of O2 consumption, O2- and beta-glucuronidase release and Staphylococcus aureus killing. Whole saliva, on the contrary, depressed all tested phagocytic activities.

Adult↗

PubMedDate not supplied

[Bacterial translocation in a model of intestinal obstruction. II. Bacteriological study and role of cellular immunity].

Bacterial translocation (Bt) from the gastrointestinal (GI) tract to systemic organs creates the possibility of Infection and sepsis in a great number of pathologic entities. In a mouse model of Intestinal Obstruction (IO), we evaluated the type of micro-organisms and the organs that bacteria frequent translocated. At 24 hours post-10, positive cultures where obtained at the MLN, portal, systemic circulation and peritoneal cavity, establishing that the translocation is bi-directional. The more frequent bacteria isolated were the Streptococcus group D, Proteus mirabilis, Escherichia coli, Pseudomonas sp., an clostridium. BT occurs at 24 hour post-OI and was due to increased intestinal permeability, at 48 hrs BT increased and related to the physical disruption of the mucosal barrier in the intestinal mucosa. Cell mediated immunity (CMI) response in this model was not altered, although a progressive decrease was observed at 48 hrs it was not significant, suggesting that the CMI play no role in the pathogenesis of BT. In the Control-Laparotomy group, CMI response was increased significantly at 48 hours, suggesting that a simple laparotomy boost the immune defense response.

Animals↗

PubMedDate not supplied

[Factors involved in bacterial translocation in an experimental model of intestinal obstruction].

We designed a model of intestinal obstruction (IO) to study the histological alterations in the intestinal wall and the mesenteric lymph nodes (MLN). Therefore we used 32 Sprague-Dawley rats and under anesthesia a laparotomy was performed and the distal ileum was ligated with 3-0 silk, producing a complete occlusion. At different interval (24, 48, 72 and 96 hours) the animals were sacrificed by cervical dislocation and were histologically analyzed. At 24 hours post IO, congestion, edema and a inflammatory infiltrate were observed at the level of the lamina propia and the MLN were reactive. At 48 hours the congestion and edema increased and the intestinal mucosa began to fragment, allowing the bacteria to translocate and getting to the lymph nodes in the intestinal wall. The reactivity at the MLN increased. The observation of bacterial translocation in IO widen the scope of the alterations in this pathology, were not only absorption of toxic products and endotoxin occurs in the compromise segment and this phenomenon could explain the incidence of bacteremia and sepsis in the IO patients.

Animals↗