PubMed Health⌕ Search

Biomedical subjects

A Spinelli

Publications and source records attributed to A Spinelli.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Prognostic value of persistent thallium-201 defects that become reversible after reinjection in patients with chronic myocardial infarction.

BACKGROUND: The presence of defects at stress-redistribution thallium-201 scintigraphy is related to a higher risk of cardiac events. However, the prognostic value of defects that become reversible after reinjection is not known. In this study we evaluated the prognostic contribution of stress-redistribution-reinjection with special regard to 3-hour fixed defects that become reversible after reinjection. METHODS AND RESULTS: We studied 122 patients with chronic myocardial infarction (>2 months) and suspected or known residual ischemia, with stress-redistribution-reinjection planar scintigraphy. Thallium scans were analyzed by three observers (three segments per view, 5-point score) and classified as normal, fixed, and reversible. The lung/heart ratio was also calculated. At a median follow-up of 47 months, 10 patients had hard events (four deaths and six myocardial infarctions) (group I), 12 patients had unstable angina (group II), 12 patients underwent planned coronary artery bypass grafting or percutaneous transluminal coronary angioplasty (group III), and 86 patients had no events (group IV). The presence of fixed defects that became reversible after reinjection did not identify patients at higher risk. The number of reversible defects at 3 hours was significantly higher only in patients who underwent revascularization. Unstable angina was not predicted by any scintigraphic pattern. The variables that were statistically related to hard events by univariate analysis were increased lung uptake, reversible cavity dilation, and the number of fixed defects that remained fixed after reinjection. By Cox multivariate analysis, the strongest predictor of hard events was the presence of more than three fixed defects that remained fixed after reinjection as a marker of irreversible myocardial damage. CONCLUSIONS: (201)Tl reinjection is a useful approach for not only detecting viable myocardium but also risk stratification in patients with chronic myocardial infarction.

Angina, Unstable↗
PubMedDate not supplied

Health status and internal radiocontamination assessment in children exposed to the fallout of the Chernobyl accident.

The Chernobyl fallout caused release of radioisotope contaminants in a very large area that includes Belarus, the Ukraine, and the Russian Federation. In this study, the authors monitored the health status and level of internal contamination in 422 children who resided in the aforementioned areas and who were < or = 10 y of age at the time of the accident. The children came to Italy for a 1-mo period between 1991 and 1992. During this time, the children underwent pediatric checkups and biochemical, immunological, and thyroid analyses. All children underwent whole-body counter measurements, and urine radiotoxicological analysis was performed for 224 of them. The 24 children evacuated from Pripiat, a village very close to the Chernobyl reactor site, were selected for cytogenetic analysis. All of these children continue to have a detectable internal contamination of caesium radioisotopes. This condition is likely the result of ground and foodstuff contamination in the various areas. The children did not evidence overt pathologies related to ionizing radiation. However, minor alterations in immunological and thyroid parameters were observed in the group of the evacuated children. Traditional cytogenetic dosimetry was not possible, but the occurrence of acentric fragments was observed-indicating a persistent effect of continuous exposure to low doses of radiation.

Adolescent↗
PubMedDate not supplied

Sexual implications of gynecologic cancer treatments.

Gynecologic cancers affected 81,000 women in 1999. The disease and its associated treatment commonly pose a threat not only to the life of such patients, but also to their sexuality and fertility. These women and their partners require knowledgeable, compassionate care. Effective, holistic nursing care for women experiencing gynecologic cancers requires an understanding of basic concepts of female sexuality, the diagnosis and treatment of gynecologic malignancies, the impact of the disease and its treatment on a woman's sexuality, and ways the nurse can incorporate sexuality issues into practice.

Female↗
PubMedDate not supplied

Bone lesion in a patient with transplanted liver for a metastatic carcinoid. The role of somatostatin receptor scintigraphy.

A patient who had previously undergone ileal resection and liver transplantation for a gastroenteropancreatic (GEP) tumor was evaluated with somatostatin receptor scintigraphy (SRS) using 111In-DTPA-D-Phe1-pentetreotide. Eighteen months after surgery, during follow-up procedures, conventional imaging techniques (ultrasound, computed tomography, magnetic resonance imaging) only showed a relapse in the gastropancreatic lymph nodes, while SRS demonstrated skeletal spread. This case report emphasizes the clinical impact of SRS on the management of patients affected by neuroendocrine gastroenteropancreatic tumors.

Adolescent↗
PubMedDate not supplied

Nocardia keratitis: a case report.

PURPOSE: To describe a case of Nocardia keratitis resistant to 2% amikacin, with a toxic-allergic reaction to fortified topical 5% amikacin, and recurrence of the infection with topical corticosteroids. METHODS: Nocardia was diagnosed from a smear and positive culture and identified as Nocardia asteroides by gas chromatography and quantitative fatty acid analysis using the Microbial Identification System. Treatment was started with topical 2% amikacin, which was subsequently raised to 5% because of clinical resistance. RESULTS: A toxic-allergic reaction was observed after 5% amikacin so the drug was discontinued and commercially available drugs combining 1% chloramphenicol, 0.5% tetracycline, and 18 mil IU colistin with 0.3% ofloxacin were given. These were well tolerated and the infection improved quickly. After 1 month the antibiotics were discontinued and topical 0.1% clobetasone was given to reduce scar formation. The infection recurred after 1 week but responded to 3 months of the previous antibiotic combination and its sensitivity was checked with the Epsilometer test. CONCLUSIONS: Nocardia keratitis may not respond to 2% topical amikacin and fortified topical 5% amikacin may cause a strong toxic-allergic reaction. A commercially available combination of chloramphenicol, tetracycline, and colistin, with ofloxacin, may be effective but the treatment must be continued for several months. Topical steroids should only be used with considerable caution since they can lead to relapse of the infection.

Adult↗
PubMedDate not supplied

Hyperopia correction using an erodible mask excimer laser delivery system coupled to an axicon: preliminary results.

PURPOSE: This paper presents the results of the first human trial on the correction of hyperopia using an erodible mask excimer laser delivery system coupled to an axicon. METHODS: We treated 17 eyes of 17 patients (age range 34-62 years) for the correction of +3.21 +/- 1.04 D (range +1.00 to +4.00 D). The hyperopic correction was made using an erodible mask inserted on the laser optical pathway, to produce a circular ablation measuring 6.5 mm in diameter. An axicon was then used to create a blend transition zone from 6.5 mm up to 9.4 mm in diameter. Eyes were evaluated at one, three and six months after surgery. RESULTS: Reepithelization was always observed by the fifth postoperative day, despite the large area of deepithelization (diameter 9.5 mm). Mean refractive error one month after treatment was -2.44 +/- 1.59 D (range 0.00 to -6.50 D). Five eyes (29.4%) had a best corrected visual acuity loss more than two to three lines; all eyes showed mild annular haze not involving the central part of the cornea. Six months after treatment, mean refractive error was -0.88 +/- 0.99 D (range +0.50 to -3.00 D). Compared to preoperative status, 13 eyes (76.5%) showed an improvement in uncorrected distance visual acuity (1-8 lines), and 14 eyes (82.4%) showed an improvement in uncorrected vision at reading distance (3-7 lines). Two eyes (11.7%) showed a best corrected visual acuity loss of two of three lines. CONCLUSIONS: These preliminary results indicate this approach is effective in reducing hyperopia, while its predictability has still to be proved in a larger treatment group with longer follow-up. A cautious approach to this technique is still advisable, especially for higher hyperopic corrections, in view of the large best corrected visual acuity loss seen in two eyes at six months.

Adolescent↗
PubMedDate not supplied

Radioimmunotherapy trials in germ testicular carcinoma: a phase I study.

Two patients with germ cell testicular cancer were submitted to radioimmunotherapy (RIT) by using the monoclonal antibody 131I-radiolabelled (MoAb) H17E2, raised against placental alkaline phosphatase (PLAP). Both patients had been previously treated with repeated chemotherapy regimens assisted by autologous bone marrow transplant (ABMT), that, in the end were unsuccessful, thus necessitating further experimental treatment. RIT was well tolerated and the targeting of multiple neoplastic lesions was satisfactory. Nevertheless, the clinical results of treatment were minimal owing to the extension of the tumour. The data obtained suggest the possibility of applying this form of treatment in patients with minimal residual disease after previous traditional chemotherapy regimens.

Adult↗
PubMedDate not supplied

Radioimmunotherapy of gastrointestinal cancer and glioblastomas.

Two groups of patients with gastro-intestinal (GI) tumours (41) and recurrent glioblastoma (GBM), (17) underwent radioimmunotherapy after the failure of traditional treatments. A number of different MAbs were employed (anti-CEA and anti-Tenascin) which were labelled with I-131. The radiopharmaceuticals were administered by the intraperitoneal and intratumoral routes. As a rule the cycles were repeated to enhance the effectiveness of RIT. No significant early or late adverse effects were recorded. HAMA development was observed in all GI cases but only in a few GBM patients. The cumulative dose delivered to the target tumors was considerable (mean 8,900 cGy) in the GI group, and was much higher in the GBM patients (mean 51,700 cGy) owing to the particular modality of injection. Survival improved in both series of patients. The objective responses to RIT were promising: in the GI group 10 complete remissions (CR) and 6 partial remissions (PR) were observed, while in the GBM group 3 long-lasting CRs and 3 prolonged PRs were documented.

Brain Neoplasms↗
PubMedDate not supplied

[Spontaneous abortion in Italy: social differences and temporal trends].

Spontaneous abortion in Italy between 1980 and 1993 has been analysed with particular reference to temporal trends and to indicators of social status (level of education and occupation of the women). Each year about 50,000 spontaneous abortions are notified in Italy and the trend is slightly increasing. The national rate passed from 8 to 9 spontaneous abortions per 100 conceptions during the period 1983-93. Geographically, the rate decreases from North to South (respectively from 11-12 to 6-8 spontaneous abortions per 100 known conception in 1993). The national rate of spontaneous abortion is slightly higher for women with little or no education: 9.0 per 100 known conceptions for women with no or primary school certificate (schooling from 6 to 10 years), 8.8 for those with lower school certificate (ages: 11 to 13 years) 7.8 for high school certificate (ages: 14 to 18 years) and 8.3 for university degree, in 1991. There were no significant differences between occupations, excepting agricultural workers who had the lowest rate: 4.1 per 100 known conceptions compared with 8.2 for women employed in industry, 9.3 for other occupations and 8.9 for housewives, students or the unemployed, in 1991. However, maternal age is confirmed to be a more important risk factor: the risk of spontaneous abortion increased from 6-7 per 100 known conception among women aged less than 30 to 20 per 100 among women aged 40 or more. The same effects are found in a logistic regression model.

Abortion, Spontaneous↗
PubMedDate not supplied

[Health conditions of immigrant women in Italy].

The number of immigrant women in Italy has increased from 260,000 in 1991 to at least 750,000 in 2003. This article describes the health situation of these women, in particular it deals with reproductive health. Immigrant women are generally young, in good health and they go to the health services mainly for pregnancy, delivery, spontaneous and induced abortion. Forty-eight per cent of acute hospital admissions and 56 per cent of day hospital admissions in 2002 were related to reproduction. Among foreign citizens, the induced abortion rate is three times higher than that reported among Italians, while the risk of spontaneous abortion is similar (97 per thousand and 101 per thousand, respectively). In general, the data show that immigrant women in Italy live in deprived social conditions, which can influence their reproductive choices and their access to health services. In order to take account of their particular needs, it is necessary to modify the health services and plan public health interventions especially for the prevention of induced abortion.

Abortion, Induced↗
PubMedDate not supplied

[Supraventricular tachycardia with PR interval shorter than RP interval. Electrogenetic mechanisms and diagnostic criteria].

The Authors report their experience on the different clinical-electrocardiographic patterns of tachycardias with P'R interval shorter than RP'. The electrocardiographic criteria, in basal conditions and after autonomic stimulation, and the role of electrophysiologic study, particularly in transesophageal way, are discussed. Finally the Authors propose a noninvasive diagnostic algorithm for a correct clinical approach.

Algorithms↗
PubMedDate not supplied

Immunoscintigraphy of primary and metastatic colorectal cancers with radiolabelled monoclonal antibodies anti-CEA.

Thirteen patients with a diagnosis of primary colorectal tumour and 68 patients previously operated for colon cancer underwent an immunoscintigraphy carried out with monoclonal antibodies anti-CEA F(ab')2, labelled with 131I or 111In. These studies led to the detection of all primary tumours and of most of their associated lesions (7/8). In this group 15 neoplastic deposits previously undetected were demonstrated, allowing an improvement in the patient staging before the operation. In the group of the 68 operated patients, immunoscintigraphy succeeded in imaging 96 out of 121 known lesions: the best outcomes were obtained for abdominal and pelvic recurrences as well as for lymph nodes lesions. The lowest levels of sensitivity were observed for liver metastases. An enhancement of the immunoscintigraphy sensitivity was obtained when the radiopharmaceutical was injected intraperitoneally. In 50 patients, this alternative administration route was successful in detecting 91/107 cancer deposits and, in particular, liver metastases were found out in 36/42 cases.

Antibodies, Monoclonal↗