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Biomedical subjects

A Pellanda

Publications and source records attributed to A Pellanda.

7 recordsLinked to original sources

Esophageal cytology in the follow-up of patients with treated upper aerodigestive tract malignancies.

BACKGROUND: Patients with an history of carcinoma of the upper aerodigestive tract are at high risk for recurrence or the development of new tumors in this region. In the majority of follow-up protocols, these patients undergo radiologic and endoscopic evaluation as a means of surveillance for the early detection of recurrence. The brush biopsy-capsule technique represents a noninvasive and inexpensive screening device for this patient population. In the current study, the authors retrospectively assessed the sensitivity, specificity, and predictive value of esophageal brush-capsule cytology for the detection of malignant lesions of the upper aerodigestive tract in this high risk patient population. METHODS: Cytologic specimens from 334 patients with previously treated upper aerodigestive malignancies were available for review. The cytologic, endoscopic, and clinical follow-up of each case were studied over a follow-up period of 3 years. Gold standard was the clinical follow-up for the negative cases (who were not submitted to biopsy) and biopsy for the positive cases. Sensitivity, specificity, and predictive value were calculated. RESULTS: Using cytology 33 malignancies were detected in 25 patients during a 3-year follow-up period. The test was found to have a sensitivity of 88.7% and a specificity of 90.7%. In 66% of cases the malignancies were located in the oropharynx; the others were located in the esophagus. In 70% of cases the malignancies were detected at an early stage. CONCLUSIONS: Esophageal brush-capsule cytology is a simple noninvasive technique that has been proven to be useful in the early detection of metachronous and recurrent neoplasms in the follow-up of patients with previously treated carcinomas of the ear, nose, and throat.

Adult↗

The anterior mandibular positioning device for the treatment of obstructive sleep apnoea syndrome: experience with the Serenox.

Anterior mandibular positioning devices are seldom used at present in the treatment of obstructive sleep apnoea syndrome (OSAS). The aim of our study was to evaluate the efficiency, the side-effects and the patient compliance with one type of device made in Switzerland, the Serenox. This device is designed to keep the mouth closed with the mandible forward, avoiding the vibration of the soft palate. Between January 1996 and October 1997, 15 patients with OSAS were treated using a Serenox. One of them stopped using the device after 6 weeks due to the persistence of temporomandibular joint pain. Serenox was successful in 13 of the remaining 14 patients. The median pretreatment apnoea/hypopnoea index (AHI) of 36.25/h was decreased to 5.5/h after treatment (P < 0.002). Snoring and daytime sleepiness were notably reduced. The side-effects were frequent but mild and disappeared after a few weeks of adaptation. In conclusion, 87% (13/15) of the patients were treated successfully. Indications for the use of a mandibular positioning device include snoring, upper airway resistance syndrome and light to mild OSAS without severe obesity.

Activator Appliances↗

Abrasive esophageal cytology for the oncological follow-up of patients with head and neck cancer.

OBJECTIVES: The occurrence of a second primary cancer in the esophagus in patients with head and neck squamous cell carcinoma is frequent and is associated with a poor prognosis. The aim of this study was to evaluate the yield of abrasive esophageal cytology as a means of screening for metachronous cancer of the upper aerodigestive tract. STUDY DESIGN: We retrospectively reviewed the results of abrasive esophageal cytology performed twice yearly for the screening of patients with prior head and neck cancer. METHODS: From 1987 to 1996, 320 patients treated for head and neck cancer underwent 1,673 abrasive cytology examinations of the esophagus during a mean follow-up period of 4 years. Cytological results were classified as negative, suspect, or positive for malignancy. RESULTS: Twenty-five patients without symptoms had one or more suspect or positive cytologic findings, leading to 29 endoscopic examinations. These revealed 20 premalignant or early malignant lesions of the esophagus (2 dysplasias, 18 squamous cell carcinomas), 2 glandular carcinomas, and 10 clinically unsuspected oral or pharyngeal carcinomas. In seven patients, positive cytological results were associated with clinically visible head and neck cancer. Of the 34 patients with suspect cytological results for malignancy, 10 had no evidence of tumor at endoscopy and 24 had no endoscopic examination because of refusal or because suspected cells were not found in additional examinations. Negative results on cytological examination were found for 254 patients throughout their follow-up, and none of them developed esophageal cancer during a mean follow-up period of 3 years. CONCLUSIONS: For patients with head and neck cancer, abrasive sponge cytology is useful for detecting esophageal cancer at an early stage. In addition, it may reveal unsuspected second primaries or recurrences in the head and neck region.

Carcinoma, Squamous Cell↗

Prolonged cardiopulmonary resuscitation during acute disopyramide poisoning.

A case is reported of sustained electromechanical dissociation due to deliberate disopyramide over-dosage in a young healthy girl. Circulatory recovery was achieved with standard resuscitative measures, including prolonged cardiac massage and isoproterenol infusion plus high dose calcium chloride. Neurological recovery was complete.

Acute Disease↗

[An isometric exercise for the diagnosis of chronic obliterating arteriopathies of the lower extremities].

A non invasive method for the diagnosis of occlusive diseases of the peripheral arteries and the follow-up of therapy is proposed. The method consists in the performance of an isometric effort of the inferior limbs and the Doppler detection of the dorsalis pedis systolic pressure. 41 patients with different degrees of peripheral artery involvement have been studied and the results compared with those obtained in a control group of 12 normal subjects, equally matched for ages and sex. In the normal subjects the maximal dorsiflection of the feet for 30 seconds caused a mean increase of the heart rate of 20% and no changes of the systolic blood pressure. In the patients with peripheral artery disease the isometric effort caused, contemporary to the increase of the heart rate, a decrease of the dorsalis pedis systolic pressure, that varied from 15 to 100% according to the degree of the arterial involvement. A close correlation was found between the degree of the percent reduction of peripheral systolic pressure and the entity of the arterial involvement, as evidenced by other invasive and non-invasive methods. The method proposed appears useful for a proper diagnosis of peripheral vascular diseases in those patients who cannot undergo invasive investigations or the treadmill effort test.

Adult↗