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B Beomonte Zobel

Publications and source records attributed to B Beomonte Zobel.

At least 19 recordsLinked to original sources
PubMed2006

Cetuximab and irinotecan as third-line therapy in advanced colorectal cancer patients: a single centre phase II trial.

The epidermal growth factor receptor (EGFR), which participates in signalling pathways that are deregulated in cancer cells, is frequently mutated in colorectal-cancer cells. Cetuximab is a monoclonal antibody that specifically blocks the EGFR. We evaluated the efficacy of cetuximab in weekly combination with irinotecan in metastatic colorectal cancer patients refractory to previous treatments based on oxaliplatin or irinotecan. We included 55 heavily pretreated patients (colon/rectum: 34/11, M/F: 16/29, median age 63 years, range: 27-79) whose disease had progressed during or within an oxaliplatin-based first-line chemotherapy and a irinotecan-based second-line regimen. Patients were followed for tumour response and were also evaluated for the time to tumour progression, and safety of treatment. Cetuximab was given at an initial dose of 400 mg m(-2), followed by weekly infusions of 250 mg m(-2). Irinotecan was administered weekly at the dose of 90 mg m(-2). All patients were assessable for treatment efficacy and safety response rate was 25.4% (95% CI: 21.7-39.6%); 38.2% (95 CI: 18.6-39.8%) of patients showed a disease stability as the best response. As a consequence, the overall tumour control rate was 63.6% (95% CI: 46.4-70.6%). The median time to progression was 4.7 months (95% CI: 2.5-7.1 months) and the median survival time was 9.8 months (95% CI: 3.9-10.1 months). The most common G3-4 noncutaneous side toxicities were: diarrhoea (16.4%), fatigue (12.7%) and stomatitis (7.3%). 89.1% of patients developed skin toxicity and 32.6% of cases was of grade 3-4. No allergic reactions were identified at any courses in any patients. Fever was documented in 27.3% of patients and was most commonly recorded after the first administration. Cetuximab has clinically significant activity even in heavily pretreated colorectal cancer patients progressed after both oxaliplatin and irinotecan-based chemotherapy regimens.

Adenocarcinoma↗
PubMed2003

Dysphonia and cervical hyperostosis: a case report.

We report a case of a 77-year-old man with a 3-year-history of progressive dysphonia, without dysphagia. His voice sounded breathy; the pitch and the loudness were low. He complained of a few episodes of voice breaking. At laryngostroboscopy the adduction motion of the left true vocal cord was slower than the contralateral one. A cervical spine X-ray demonstrated a generalized vertebral osteophytosis and a 3-centimeter-long anterior osteophytic spur, originating from C6. Evaluation with barium swallow showed a dislocation of the inferior cervico-oesophagus to the right, with a preservation of its lumen. Cervical-thoracic computed tomography showed a mild pressure produced by the osteophyte on the thyroid cartilage and the presence of the radiological criteria for Forestier's disease. Therefore, the presence of dysphonia in older adults without any primary laryngeal cause, indicates a radiological study of the cervical-thoracic region, in order to discover cervical osteophytosis.

Aged↗
PubMed1993

[Magnetic resonance in the assessment of critical points of impingement of the shoulder].

Impingement syndrome is caused by a conflictual status between rotator cuff, subacromial bursa and anatomic and functional acro-mioclavicular arch. The clinical signs of this syndrome include pain and functional disability in abduction and extrarotation of the shoulder. This study was aimed at verifying Magnetic Resonance Imaging (MRI) capabilities in showing the critical points of impingement and their incidence. Fifty-four cases of impingement syndrome were studied. The best visualization of functional acromioclavicular arch was obtained using a new study technique. All patients had critical points of impingement. In 65% of cases, acromioclavicular arthritis induced impingement on the supraspinatus tendon and in 35% of cases on the muscle. In 46% of the patients, impingement between coracoacromial ligament, partially thickened in 25% of the cases and totally thickened in 75%, and supraspinatus tendon was observed. In 7% of the whole of shoulders, the acromion had an uncinatus shape. MRI, thanks to its multiplanar imaging, allowed the complete evaluation of the articular structures with complex anatomy. The assessment of different types of impingement points can be considered a valuable approach to the therapeutic stage.

Adult↗
PubMed1992

[Magnetic resonance in the staging of multiple myeloma].

The authors retrospectively reviewed the MR examinations of 46 patients with clinical and laboratory findings of monoclonal gammopathies (MG). All cases had been submitted to radiographic examination which had shown skeletal involvement in 22 cases and osteoporosis in 11, with rupture of the vertebral body in 3 patients. Scintigraphy had been performed on all patients and CT on 12; 36 patients were subsequently submitted to follow-up (at 6, 12 and 24 months). MR examinations were performed with dedicated coils and standard sequences for the subjects with skeletal localizations on X-ray images. The extant cases, with no radiographic evidence of skeletal involvement, were submitted to MRI of the spine, skull and pelvis. In agreement with clinical and laboratory findings and with follow-up results (in 36 patients), MRI diagnosed MG with no skeletal involvement in 13 cases, osteoporosis in 8 (with rupture of the vertebral body in 2), asymptomatic non-progressive myeloma in 4, solitary myeloma in 3, and multiple myeloma in 18 cases. The good identification of bone marrow and its multiplanarity make MRI the method of choice in the study of patients with suspected or known gammopathies. If compared with other modalities, MRI is more sensitive and accurate in depicting the tumor, its size and relationship to periskeletal tissues, and its possible multifocality. Moreover, the technique has proven to be a valid tool during the follow-up, showing tumor response to therapy.

Bone Diseases↗
PubMed1991

[Acute instability of the shoulder in athletes. The role of magnetic resonance in therapy planning].

Magnetic resonance imaging (MRI) of the shoulder was performed to evaluate both the actual role of this technique in the study and staging of acute shoulder instability, and its potentials as diagnostic tool, with particular reference to treatment planning. Seventeen athletes with acute shoulder instability were examined. All MRI examinations, subsequent to plain radiographs, were performed within 48 hours from the traumatic event. After MRI examination, 14 patients underwent physiotherapy (2 cases were subsequently submitted to arthrotomy), and only 3 cases underwent surgical treatment in the acute phase (2 arthrotomies and 1 arthroscopy). These cases, submitted to MRI in the acute phase and subsequently to surgery, showed anterior glenoid labrum involvement with good evidence of associated skeletal lesions (Hill-Sachs lesions in 1); changes in the inferior glenohumeral ligament complex (2 cases) were also observed. In the other examined cases, MRI always provided accurate information on the glenoid labra and the anterior capsular mechanism. When the superior glenohumeral ligament was investigated (9 cases of 17), no alterations were observed. Acting as natural contrast, the presence of joint effusion allows good visualization, on T1-weighted sequences, of the structures involved by the traumatic events. Contrast resolution improvement could be obtained by employing gradient-echo T2 weighted sequences, which proved to be quite valuable for a correct depiction of the lesions involving the inferior glenohumeral ligament complex. In conclusion, MRI can be considered as a valuable diagnostic method for the early evaluation of the acute shoulder instability, since it provides information of the utmost importance for the subsequent therapeutical approach.

Adolescent↗
PubMed1991

[Pathologic conditions in pregnancy. Preliminary evaluation of the effectiveness of magnetic resonance].

Some authors suggested that MR imaging could represent an effective diagnostic alternative in the study of pathologic conditions of mother and fetus during pregnancy. To verify the actual role of MR imaging, we examined 20 patients in the 2nd and 3rd trimester of gestation, after a preliminary US examination. Fifteen patients presented fetal or placental pathologies; in 4 patients the onset of the pathologic condition occurred during pregnancy; in 1 case of US diagnosis of fetal ascites, MR findings were normal and the newborn was healthy. As for placental pathologies, our series included a case of placental cyst, two hematomas between placenta and uterine wall, and two cases of partial placenta previa. As for fetal malformations, we evaluated a case of omphalocele, one of Prune-Belly syndrome, a case of femoral asymmetry, one of thanatophoric dwarfism, a case of thoracopagus twins with cardiovascular abnormalities, two fetal hydrocephali, and three cases of pyelo-ureteral stenosis. As for maternal pathologies during pregnancy, we observed a case of subserous uterine fibromyoma, one of right hydronephrosis, one of protrusion of lumbar intervertebral disk, and a large ovarian cyst. In our experience, MR imaging exhibited high sensitivity and a large field of view, which were both useful in the investigation of the different conditions occurring during pregnancy. In the evaluation of fetal and placental abnormalities, especially during the 3rd trimester, the diagnostic yield of MR imaging suggested it as a complementary technique to US for the evaluation of fetal malformations and of intrauterine growth retardation.

Adult↗
PubMed1990

Magnetic resonance imaging in the localization of undescended abdominal testes.

In children with nonpalpable undescended testes, preoperative localization is very helpful prior to surgical investigation both to reduce the time required for complete exploration and to plan the correct surgical procedure. Magnetic resonance imaging (MRI) was accomplished in 23 patients with a clinical diagnosis of cryptorchidism after ultrasonographic studies were inconclusive in identifying the undescended testis. An abdominal testis was correctly located in 16 cases. No structures resembling testicular parenchyma were detected in 4 instances. The surgical findings confirmed the absence of testes in 2 patients but showed 2 abdominal testes not seen by MRI. The movements of 5 patients caused inadequate MRI examinations, so these patients were not considered in the results. In our experience MRI proved to be effective in locating undescended abdominal testes with a diagnostic accuracy of 90%. Therefore MRI should be performed before any invasive diagnostic procedure. Lack of cooperation in young patients could reduce the accuracy of the procedure, so we think that sedation should be performed in children under 6 years of age.

Abdomen↗
PubMed1990

[Clinically manifest or silent primary and secondary syringomyelia. The magnetic resonance findings].

The MR scans were retrospectively reviewed of 40 patients who had been diagnosed as having syringomyelia. Our results demonstrate that syringomyelia can be found in asymptomatic patients as well as in many with atypical symptomatology. Our study stresses MR efficacy in investigating this pathologic condition. As a matter of fact, MR allowed us to visualize the cavity, its extension, the eventual association with Arnold Chiari type-I malformation and/or syringobulbia. In all cases cord enlargement and the presence of septations could also be demonstrated. In most cases the possible pathogenesis of syringomyelia could also be supposed.

Adolescent↗
PubMed1989

[Magnetic resonance of the prostate: critical evaluation of diagnostic possibilities].

The authors retrospectively reviewed 140 MR examinations of the prostate to assess the presence of similar findings in the different patients affected with the same prostatic disease. In 35 patients with acute phlogosis, MR imaging showed enlargement of peripheral gland, with increased signal intensity on T2-weighted images, while reduced peripheral gland with low signal intensity was demonstrated in chronic phlogosis. Five patients presented roundish cystic lesions, with clear-cut outlines, clearly distinguishable from the surrounding parenchyma. Benign Prostatic Hyperplasia (BPH) was observed in 32 cases. 52% of them had multiple nodules with high signal intensity, 40% had hyperintense enlarged central glands, with no evidence of BPH nodules, and the remaining 8% presented single/multiple nodules with low signal intensity. In 56 patients with prostatic carcinoma the tumor extent ranged from 18-20 mm nodules to 5-6 cm masses with involvement of periprostatic adipose tissue or surrounding organs. The smallest lesions were always found in the peripheral gland and had low signal intensity on T2-weighted sequences. In spite of the different findings in the patients affected with BPH, the study proved MR imaging to be able to distinguish the various patterns of the different prostatic diseases.

Adolescent↗
PubMed1989

[MR characterization of breast pathology using inversion recovery sequence].

As yet, a valid tissue characterization of human breast diseases has not been possible with conventional MR techniques. On the basis of the experimental thesis according to which fibroadenomas and carcinomas have a slight, though significant, difference in T1 relaxation times, we employed specific inversion recovery sequences at the T null of the breast glandular and adipose tissues, to enhance the differences in the signal intensities of the various pathologies. We examined 16 (6 cystic dysplasias, 5 fibroadenomas, 3 carcinomas, and 1 phylloid fibroadenoma) selected patients with the above-mentioned sequences in addition to the routine T1- and T2-weighted spin echo sequences. The following conclusions were reached by evaluating the characteristic signal intensities: MR spin echo sequences allow solid lesions to be distinguished from cystic ones; MR inversion recovery sequences allow fibroadenomas to be distinguished from carcinomas with 88% accuracy.

Adenofibroma↗
PubMed1989

[Magnetic resonance of the shoulder: technic, anatomy ana clinical results].

MR imaging was employed in 232 patients with traumatic or degenerative lesions of the shoulder. MR diagnosis was compared with arthrotomic findings in 19 cases, and with arthroscopic results in 3 cases. MR technique is here presented and the choice of scanning planes is discussed, together with the sequences of image acquisition and with the features of the surface coil employed. Axial, sagittal, and coronal scans were used in all cases. Both sagittal and coronal planes were performed obliquely on the basis of precise anatomical structures. T1-weighted sequences were used for they are reliable in locating the various anatomical structures and efficient in defining the several different pathologic conditions. The role of T2-weighted sequences was complementary, and they were employed in selected cases only. A surface coil is presented with a particular configuration of easy clinical use and with such technical features as to allow reduced fields to be imaged, with good spatial resolution. MR imaging could demonstrate with equal accuracy both skeletal-cartilage components and capsulo-ligamentous structures, thus defining associated lesions and small tears. In both degenerative and traumatic lesions of the rotator cuff, MR imaging showed both extent and entity of the pathologic process, with high accuracy in defining the impingement syndrome. MR imaging allowed the depiction of the anterior and posterior glenoid labra, even without intraarticular contrast media. Moreover, MR imaging made it possible to recognize both fractures and degenerative processes within the glenoid labrum on the basis of their signal intensities. This preliminary experience allows the authors to conclude that MR imaging is an accurate and non-invasive diagnostic method for the study of traumatic lesions and of degenerative changes of the shoulder.

Adult↗
PubMed1988

[Magnetic resonance of the breast. Clinical experience with a dedicated coil].

MR Imaging was performed on 10 healthy volunteers and 86 patients, using a 0.5 T superconducting magnet and a dedicated coil to image both breasts simultaneously. The patients were selected by the presence of nodules at clinical examination. Final diagnoses were made either at histology--in the patients who underwent surgery--or at cytology, with fine needle biopsy. The MR findings of the different breast diseases are discussed. In spite of an improved spatial resolution and of a very good natural contrast between different tissues, MR Imaging does not allow a satisfactory characterization of the lesions; its use is thus limited to the staging of cancers which need a better therapeutic planning.

Adenofibroma↗
PubMed1988

[Osteosarcoma. A new diagnostic approach in presurgical loco-regional staging].

The value of Magnetic Resonance (MR) imaging was examined in the anatomical staging of bone osteosarcomas. Eleven patients were studied--8 central and 3 parosteal osteosarcomas. The accuracy of MR imaging was compared to that of plain film, scintigraphy, CT, and angiography. MR imaging was superior to both CT and radionuclide scanning in defining intramedullary extension and in showing skip metastases. Cortical erosion in central osteosarcomas was demonstrated by MR imaging, CT, and plain film; in 1 case of parosteal osteosarcoma MR imaging was superior to CT in showing cortical penetration. In two cases MR imaging did not accurately demonstrate the relationship of the tumor to the major vessels; only angiography showed vascular involvement. MR imaging was useful in delineating extraosseous extension. The importance is stressed of a correct use of MR imaging towards an accurate diagnosis. In fact, intramedullary extension and skip metastases were better demonstrated on T1-weighted images with large fields, while T2-weighted images and small fields were needed for the best overall evaluation of extraosseous involvement. In conclusion, MR imaging should be used for preoperative staging of osteosarcomas in those cases where diagnosis was made on the basis of clinical, radiographic, and bioptic findings.

Adolescent↗
PubMed1988

[Magnetic resonance study of renal function. Preliminary evaluation].

The amount of functioning renal parenchyma can be estimated by MRI by considering the ratio between the mean intensities of cortical and medullar zones of the kidney. Fifty-six patients and 5 healthy volunteers were studied by MRI in our department. Scanning was performed with a superconductive magnet system operating at 0.5 Tesla. Pulse sequence was Spin-Echo with TR 300/TE 30 ms. The cortico-medullary ratio (CMR) and differentiation (CMD) were standardized and related with creatine blood levels. CMR data ranged from 1.05 to 3.00, while CMD data ranged from 0.04 to 0.50. High values (good cortico-medullary contrast) were observed in subjects with normal renal function. Patients with renal diseases had low CMR and CMD, proportionally to the degree of renal failure, as proved by laboratory findings. Our preliminary study seems to demonstrate that MRI is an useful technique in the follow-up of patients with chronic renal disease.

Creatinine↗