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Biomedical subjects

C Penna

Publications and source records attributed to C Penna.

At least 91 records · Page 5Linked to original sources
PubMed1993

Operation and abdominal desmoid tumors in familial adenomatous polyposis.

Abdominal desmoid tumors (ADT) have become an important problem because of the increased survival of patients with familial adenomatous polyposis (FAP). Of 240 patients operated upon for FAP between 1978 and 1991, 29 (16 men and 13 women) had ADT. Diagnosis was made at laparotomy in 19 patients, while an abdominal mass or intestinal obstruction was the principal cause of discovery in the ten remaining patients. Twenty ADT were discovered after a previous laparotomy performed an average of three years earlier. Nine ADT occurred in 146 patients who had previously undergone a coloproctectomy and ileal pouch-anal anastomosis and eight occurred in 74 patients who had abdominal colectomy and ileorectal anastomosis. Desmoid tumors were responsible for eight instances of intestinal obstruction and one instance of small intestinal perforation. One death was directly related to ADT. In four of nine patients, ADT was responsible for a deterioration of the functional results of ileoanal anastomosis, but pouch removal was not necessary. Conversion of ileorectal anastomosis to ileoanal anastomosis and excision of carcinomas that occur in the residual rectum after ileorectal anastomosis were impossible because of ADT in three and two patients, respectively. Complete surgical removal of the tumor was possible in seven patients only and four patients had a recurrence. None of the medical therapies used (sulindac, tamoxifen and chemotherapy) were effective. The results of this study confirm the high incidence, severity and absence of effective treatment of ADT in FAP. Desmoid tumors occurring after ileorectal anastomosis seem to be more severe than after ileoanal anastomosis because, in the former instance, they may interfere with the further management of the rectal stump.

Abdominal Muscles↗
PubMed1992

Epilepsy: patient perceptions of their condition.

The objective of this study was to ascertain the perceptions of people with epilepsy about their condition. Nine hundred and eight questionnaires were sent to members of epilepsy associations, with a 45% response rate, and 625 questionnaires were sent to neurologists for their patients to complete, with a response rate of 16.5%. The results reinforce and extend previous observations that there is an ongoing need for educating health care professionals and persons with epilepsy about the condition. Matters pertaining to driving, the unpredictability of seizures, lack of employment and cognitive difficulties were of major concern to the respondents. The present data also highlighted the vexed relationship between stress and seizure control, which needs to be further investigated. These data should be of value to doctors and other health care professionals in their dealings with people with epilepsy. It should also provide epilepsy associations with data upon which they might be able to plan education services.

Activities of Daily Living↗
PubMed1991

[Treatment of female genital condylomatosis with intramuscular beta interferon].

Intramuscular injections of beta-interferon were used to treat a first group of 64 outpatients with clinically diagnosed genital condylomata at single doses of 3 x 10(6) IU for 10 consecutive days. A second group of 30 patients affected by HPV genital infection has been treated with placebo intramuscular injections. Patients were checked at 3, 6 and 12 months after therapy and twice during a one year follow-up after the disappearance of the warts. In the first group 29 patients (45.3%) were cured after 3 months, another 6 after 6 months and 1 patient after one year. In the second group only 3 (10%) patients were cured after 3 months, while in 2 cases (6.7%) lesions disappeared after 6 months (p value less than 0.001). Therapy was most effective on flat lesions in the cervical area. Follow-up of the patients with complete regression of lesions showed three recurrences of condylomatous lesion.

Condylomata Acuminata↗
PubMed1989

[Use of topical methisoprinol (Viruxan) in female genital condylomatosis].

Medical therapy of genital condylomatosis seems to be the most rational strategy, since this pathology is characterised by highly frequent recurrences after destructive physical therapy alone. Successful therapy of female genital condylomatosis with methisoprinol (Viruxan), administered as ointment and/or vaginal ovules is reported. The drug proved to be efficient both in curing this viral infection and preventing its recurrences.

Administration, Topical↗
PubMed1989

[Viral infections and neoplasms of the uterine cervix].

Since the last century, epidemiological studies of cervical carcinoma have shown a close link with sexual activity and in particular with promiscuity starting at an early age. Aetiological research has therefore concentrated on identifying sexually transmitted pathogens. In recent years studies have focused on the apparently significant role of HSV and particularly HPV in the aetiopathogenesis of this tumour. After the first cytohistological findings the HPV-cervical cancer link has been confirmed by electron microscopy, immunohistochemical studies and hybridisation of viral DNA. The identification of different HPV types presenting varying degrees of oncogenic risk offers the prospect of reaching a reliable prognosis on the basis of the particular virus identified in the lesion. The hypothesis that the virus has a decisive influence on the biology of th tumour is also intriguing: findings on the incidence and course of cervical cancer in the youngest women seems to suggest tha HPV may be a fundamental tumour growth factor.

Female↗
PubMed1981

Colposcopy and cytology in young women up to the age of 20: an analysis of 401 cases research for a new screening programme.

The Authors have observed by colposcopy and cytology, 401 patients under the age of 20 and have compared the results obtained with those of a similar control group with ages ranging from 20 to 25. They observed the incidence of normal cervix and of other colposcopic reports. From the comparison between the colposcopic and cytologic data emerged that the cytopathologic diagnosis does not put the cervical alterations of inferior level than dysplasia in evidence, in a large number cases as colposcopy does. There is a very close relation between the incidence of pathologic cervical lesions and sexual activity. Correlation between cervical pathology and use of hormonal contraceptives and presence of cervico-vaginal phlogosis, was not possible in this type of survey. The Authors therefore propose a new type of mass screening, which should substitute the actual one, that is substantially based on cytology and on early diagnosis rather than prevention.

Adolescent↗
PubMed1981

Combined systemic and topical treatment of trichomoniasis vaginalis with azanidazol.

The Authors report the results obtained using Azanidazol on a group of 55 patients affected by Trichomoniasis and studied in the Colposcopic Section of the Obstetric and Gynecological Clinic of the University of Florence. The study was carried out on two groups of patients using two different treatment methods. Complete recovery was reported in 93.4% of the cases in the first group and 100% of those in the second group. Tolerance of the preparation was very high.

Administration, Oral↗
PubMed1981

Colposcopy and cytology in young women up to the age of 20: an analysis of 401 cases research for a new screening programme.

The Authors have observed by colposcopy and cytology, 401 patients under the age of 20 and have compared the results obtained with those of a similar control group with ages ranging from 20 to 25. They observed the incidence of normal cervix and of other colposcopic reports. From the comparison between the colposcopic and cytologic data emerged that the cytopathologic diagnosis does not put the cervical alterations of inferior level than dysplasia in evidence, in a large number cases as colposcopy does. There is a very close relation between the incidence of pathologic cervical lesions and sexual activity. Correlation between cervical pathology and use of hormonal contraceptives and presence of cervico-vaginal phlogosis, was not possible in this type of survey. The Authors therefore propose a new type of mass screening, which should substitute the actual one, that is substantially based on cytology and on early diagnosis rather than prevention.

Adolescent↗
PubMedDate not supplied

High-grade cervical intraepithelial neoplasia (CIN) in pregnancy: clinicotherapeutic management.

UNLABELLED: An increasing incidence of cervical intraepithelial neoplasia (CIN) among young women has been noticed in recent years. For this reason pregnancy might represent a peculiar opportunity to undergo cytocolposcopic examination for those women who do not take part in a screening program for cervical carcinoma. Diagnosis of CIN during pregnancy poses the question of the management of this disease and particularly of whether it is better to treat the lesion or not during pregnancy. To contribute to the solution of this issue we initiated a study on the management of high-grade CIN in pregnancy. MATERIAL AND METHODS: Five hundred and seventy-one pregnant women underwent cytologic, colposcopic and, when necessary, histologic examination. Those in whom a CIN was discovered in the first four months of gestation underwent laser conization. When the diagnosis of CIN was made after the sixteenth week of gestation, cytocolposcopic monitoring was performed every eighth week during pregnancy and two months after childbirth. Laser conization was performed under colposcopic guidance in the outpatient setting in all cases. All treated patients were submitted to cytologic, colposcopic and, if necessary, histologic examination every third month in the first year after treatment, every sixth month in the second year and yearly from the third year onwards. RESULTS: In 14 (2.4%) of the 571 examined women a CIN III was discovered, 6 of which associated with a human papilloma virus (HPV) infection. Of these, 8 patients, whose diagnosis was made within the sixteenth week of pregnancy, underwent laser conization. In one case a minor hemorrhage occurred during treatment. Two patients reported minor bleeding up to ten days after treatment. No major hemorrhages or cervical stenosis were observed. Histologic examination of the cones confirmed the preoperative diagnosis based on cervical biopsies and the lesion was entirely removed by conization in all cases. Seven of the 8 patients who underwent laser conization during pregnancy had a spontaneous delivery at term. The remaining patient, who had had a previous cesarean section, was again delivered by cesarean section. All treated patients were cured after the first-year follow-up visit. In 6 patients CIN was diagnosed after the sixteenth week of pregnancy. These women underwent cytocolposcopic examination every eighth week during pregnancy and two months after delivery, when the cervical changes associated with gestation had disappeared. Four of these patients showed persistence of CIN at postpartum follow-up and therefore underwent laser conization. In two patients spontaneous regression of the lesion was observed. In no case did progression to invasive carcinoma occur. CONCLUSIONS: Given the increasing incidence of CIN in young women, the beginning of pregnancy may represent a peculiar opportunity for all pregnant women who do not take part in cervical screening programs to undergo a cytocolposcopic examination. In case of a diagnosis of high-grade CIN within the first 16 weeks of pregnancy, a conservative excisional treatment, which does not expose the pregnancy to any risk, should be carried out in order to confirm the intraepithelial localization of the lesion.

Adult↗
PubMedDate not supplied

Prolonged survival after resection of pancreatoblastoma and synchronous liver metastases in an adult.

Pancreatoblastoma is an uncommon pediatric neoplasm with distinct acinar and squamoid cell differentiation. Pancreatoblastoma is exceedingly rare in adults with only ten reported cases. Pancreatoblastoma in adults has a poor prognosis and no survival without recurrence exceeding 30 months has been reported. We report the first adult case of pancreatoblastoma revealed by gastric bleeding due to segmental hypertension. On computed tomography scan, the tumor appeared lobulated and extended from the splenic hilum to the portal vein. Two hypervascular centimetric hepatic metastases were observed in segments III and VII. The patient was operated and a distal pancreatectomy with splenectomy associated with two hepatic wedge resections was performed. The diagnosis of pancreatoblastoma was made on immunohistochemical examination. The patient received 6 cycles of adjuvant therapy. After three years of follow-up, the patient was well with no sign of recurrence on computed tomography scan. This case suggests that in the presence of pancreatic tumor of unknown origin, aggressive management including complete surgical resection and adjuvant chemotherapy should be attempted even in the presence of synchronous liver metastases.

Chemotherapy, Adjuvant↗
PubMedDate not supplied

"Side" effects of HAART: decreasing and changing occupational exposure to HIV-infected patients.

To investigate percutaneous exposures to HIV in the highly active antiretroviral therapy (HAART) era, we performed an analysis of all percutaneous exposures reported from January 1994 to December 1998 in 18 Italian acute-care hospitals. Frequency and rate per 100 prevalent AIDS cases of HIV exposures decreased by 40% (from 4.3% to 2.6%, and from 1.0% to 0.6%, respectively; p<0.001), which were mainly those related to the insertion/manipulation of peripheral vascular access devices (from 7.2% to 4.8%; p=0.05). We conclude that the benefits of HAART have changed the complexity of care required and therefore, the number and type of procedures performed on HIV patients that place the HCW at risk of injury.

Antiretroviral Therapy, Highly Active↗