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Biomedical subjects

C Vincenzoni

Publications and source records attributed to C Vincenzoni.

At least 19 recordsLinked to original sources
PubMed2002

[The role of some micronutrients in the evolution of HPV infection].

BACKGROUND: Over the past few years a series of research projects has shown that the scant or deficient immune response in HIV infection may be secondary to reduced cell resistance and/or the uncontrolled formation of free radicals. In line with these findings, subjects with HIV infection present a deficit of polyunsaturated fatty acids (the principal components of cell membranes) and many antioxidating substances, like Vitamin E and glutathione peroxidase. The high incidence of heterosexual transmission of HIV has now shown the close correlation between HIV infection and HPV infection. By analogy, we wanted to ascertain whether these deficits were also present in subjects with HPV infection and dysplastic and neoplastic lesions of the uterine cervix. Published data confirm that a HPV-positive subject has an increased risk, ranging from 40 to 200%, of contracting HIV infection. METHODS: Eighty women with HPV infection of the genital tract, at various stages. Blood levels of vitamin E and polyunsaturated fatty acids were measured using gas-chromatography; glutathione was assayed using the spectrophotometric technique. RESULTS: The alternation of the aforesaid parameters is correlated to the progress of infection and increases with the severity of lesions; Statistically significant data were recorded by comparing the group with condylomatosis with patients diagnosed with cervical carcinoma (p<0.001). CONCLUSIONS: The increased possibility that some patients are affected by an association of HPV and HIV depends on the anomalous or scarce function of many immunocompetent cells, as well the quantitative immune deficiency induced by the initial virus and the presence of various mechanisms that facilitate the development of the infection.

Adult↗
PubMed2002

[Laser conization for cervical intraepithelial neoplasias, grade III. Personal experience of 77 cases].

BACKGROUND: Evalutation of the efficacy of laser conization for cervical high-grade squamous intraepithelial lesions (Hg-SIL). METHODS: A retrospective evaluation. Case collection: A total of 77 women, 47 outpatients and 30 inpatients with endocervical CIN3 or CIN2, were treated by carbon dioxide (CO2) laser between 1993 and 1995. A preoperative diagnosis has been made by means of Pap-smear, colposcopy and marked biopsy. In 47 cases a laser conization was performed in Day Surgery, without vessel constrictors or local anesthetics. In 30 cases a narcosis (Diprivan ) was induced. The former were discharged 2-3 hours and the latter 24 hours after treatment. RESULTS: The histological examination confirmed preoperative diagnosis in 64 (86.5%) cases and negligible one grade discrepancy was reported in 7 cases (6 over- and 1 underestimated); missed invasion and no free margins were reported in the remaining 4 and 2 patients respectively, so these latter 6 patients were submitted to other surgical procedures. No serious complications occurred with the exception of mild vaginal postoperative bleeding. During the follow-up of 36-82 months, cervical alterations were described only in 12 out of 71 cases, flat condilomatosy in 8 cases, CIN2 in 2 patients and CIN3 in other 2 patients. At present, all the patients are free of disease. CONCLUSIONS: The conization with dioxide laser is a good therapy for cervical intraepithelial neoplasia, even if expensive; infact poor side-effects are observed as well as a very good reliability.

Adult↗
PubMed2001

Thyroid tumors in children and adolescents: preoperative study.

Several studies indicate that in young patients (less than 21 years of age at the time of diagnosis), the prognosis of thyroid carcinoma (TC) is more favorable than in older patients. However, a more radical treatment approach is recommended in children and adolescents due to the higher prevalence of local lymph-node involvement in these cases. Since the extent of primary surgical treatment is closely related to the overall prognosis, preoperative diagnosis becomes essential in the management of thyroid neoplasms in young patients. In this retrospective study (1987-1998), we analyzed a surgical series of 50 children and adolescents with thyroid nodules in an attempt to establish the role of diagnostic studies in detecting malignant lesions prior to surgery. Our diagnostic protocol for evaluating thyroid nodules was based on clinical evaluation, measurement of thyroid-hormone and thyroglobulin (TG) levels, anti-TG and anti-TPO antibody titers, calcitonin, CEA, and TPA levels, sonography, scintigraphy, and fine-needle aspiration cytology (FNAC) of the thyroid nodules and any enlarged lymph nodes. Eleven of the 15 cases of histologically confirmed carcinoma were preoperatively identified as malignant lesions with the aid of FNAC. The authors conclude that the preoperative work-up of children and adolescents with thyroid nodules requires the collaboration of an experienced team of professionals, and recommend FNAC as the initial test.

Adolescent↗
PubMed2000

Combined Surgery for cardiac and carotid disease: management and results of a rational approach.

OBJECTIVES: The aim of the present study was to apply a rational plan for simultaneous cardiac and carotid surgery in high-risk patients. MATERIALS AND METHODS: A consecutive series of 89 patients with coexisting severe cardiac and carotid disease were operated on during a 5-year period with routinary carotid shunting, moderate hypothermia and balanced anaesthesia. The combined surgical procedures were coronary artery by-pass grafts (CABG) + carotid endarterectomy (CEA) in 81 patients, CABG + CEA + aortic valve replacement (AVR) in four patients, and four cases of CEA + AVR. RESSULTS: Two deaths (2%), three acute myocardial infarctions (3%) and one (1%) major stroke occurred in five patients during the perioperative (30 days) period for a combined rate of death and/or disabling stroke of 3%. There were five reversible neurological deficits. Carotid and aortic mean clamping times were 9 and 60 min respectively. Patients were discharged after a mean length of stay in Intensive Care Unit (ICU) of 131 h and 7 days of hospitalisation post-ICU. CONCLUSIONS: Based on our results, combined interventions of CEA and CABG can be performed with an acceptable morbidity and mortality when severe carotid stenosis is associated with advanced, symptomatic cardiac disease. The management of these patients needs careful and appropriate pre-intra and post-operative assessment and timing aimed to reduce the ischaemic injuries, both cardiac and cerebral, especially during CBP time.

Aged↗
PubMed1998

Leiomyosarcomas of the small intestine misdiagnosed as ovarian masses: report of three cases.

Leiomyosarcomas of the small intestine are rare lesions. Because of their aspecific symptoms, diagnosis is often made at a late stage and, in women, must be distinguished from ovarian tumors. Three cases of large, abdominal masses, evaluated preoperatively as being ovarian tumors, are presented. At histology all three were diagnosed as leiomyosarcomas of the small intestine.

Aged↗
PubMed1993

Cervical carcinoma in young patients: clinical and pathological variables.

Twenty-five (10.2%) out of 243 untreated patients with invasive cervical carcinoma were 35 years old or younger. When matching the clinical and pathological variables between the younger and the older women, the former were characterized by a higher rate of Stage IB disease (P = 0.10), G3 and G4 tumors (P = 0.25), bulky lesions (P = 0.05) and node metastases (P = 0.50). In spite of this poorer pathological profile, both the 5-year disease-free survival rate (75%) and survival according to stage of the younger women were similar to those reported in larger series, regardless of the patients' age. No modification of the standard therapy is therefore required in younger patients.

Adult↗
PubMed1991

The use of a panel of monoclonal antibodies can lower false-negative diagnoses of peritoneal washings in ovarian tumors.

A correct surgical staging of ovarian carcinoma and the identification of persistent microscopic disease at second-look surgery largely rely on the cytologic examination of peritoneal washings (PW). Nevertheless, the morphologic analysis of these fluids frequently provides false-negative findings. As shown in other areas of cytodiagnosis, monoclonal antibodies (MoAb) to tumor-associated antigens may be a useful adjunct to overcome the limitations of conventional cytopathologic examination of PW. To evaluate this question, immunocytochemical tests were done using a panel of four MoAb to ovarian carcinoma-associated antigens (B72.3, MOv18, MOv19, and OC-125) to analyze 117 PW sampled during initial surgical staging and 121 PW harvested at second-look operations. The results of this study showed that immunocytochemical tests using the combination of the four reagents could improve cytodiagnosis more than 15% in both groups of PW. Thus a significant fraction of patients could be correctly staged and treated or become potentially curable by second-line salvage therapy.

Adenocarcinoma↗
PubMed1991

[Cytological history of 101 patients with invasive cancer of the uterine cervix].

The cytological history of 101 patients affected by cervical cancer was examined. Three different groups of patients were identified: Group I included 73 women (72.3%) who had never submitted to a cytological cervical sampling, Group II included 17 (16.9%) with an unsatisfactory cytological history and Group III included 11 (10.8%) with a satisfactory cytological history. The disease stage at the time of hospitalization was evaluated in all three groups. In group I, the diagnosis of Stage I was made in 43% of the cases while in the second and third groups, this same stage was diagnosed in 75% and 80% of the cases respectively. Three of the patients from group III presented a normal cytological history, while the other 8 had an abnormal cytological response. Sixty five percent of these 8 had not been submitted to further cytological testing briefly thereafter. From an analysis of these data, the authors attempted to identify the reasons for unsuccess which are still today related to a screening program such at that for cervical cancer. Various international proposals on the organization of a screening program are considered with particular attention given to the minimum and maximum age limits of the women selected for the screening with reference to the authors' personal experience.

Adult↗
PubMed1991

[Stage I and II cervical carcinoma. Study with magnetic resonance and transrectal echography].

Twenty-five patients with histologically-proven cervical carcinoma (clinical stages I and II according to FIGO classification system) were studied by means of transrectal US (TRUS) and MR imaging (MRI) at 1.5 T, to evaluate the primary tumor and measure its size. Stage Ib cancers were divided into small 4 (less than 4 cm) and large (greater than 4 cm). The patients with large Ib and those with stage II lesions were administered preoperative radiation therapy. All the patients underwent TRUS, MRI, and clinical examination under sedation; they were subsequently operated. Stage Ia and small Ib patients underwent therapeutic surgery, while large Ib and stage II cases had surgical exploration for pathologic staging. The tumor was correctly identified and measured in 22 patients with MRI, and in 20 cases with TRUS. Tumoral involvement of parametria and uterine ligaments was demonstrated in 75% of cases by MRI and in 62.5% of patients by TRUS. Vaginal involvement was demonstrated by MRI in 77.8% of cases and by TRUS in 66.6% of patients. Tumor size could be evaluated more accurately than with clinical examination under sedation, while the results were poorer in the demonstration of tumor spread into uterus and parametria.

Female↗
PubMed1990

Four case reports presenting new acquisitions on the association between breast and endometrial carcinoma.

In recent years, the association between breast and endometrial cancer has been the subject of many studies. The present report describes four cases of this association in which tamoxifen had been administered to all of the patients. Data have been published regarding the possibility that tamoxifen may be responsible for the subsequent development of carcinoma of the corpus uteri in these patients. The authors intend to carry out a case-control study on patients treated with tamoxifen for breast carcinoma to reveal the possible presence of endometrial carcinoma.

Adenocarcinoma↗
PubMed1990

Malignant fibrous primary histiocytoma of the recto-vaginal septum.

Considering the different localizations of malignant fibrous histiocytomas (MFH), that of the recto-vaginal septum is extremely rare. The present report describes a case, probably the first in literature, characterized by a storiform-pleomorphic histological type, treated with posterior exenteration and adjuvant chemotherapy. The Authors stress the still controversial histogenetic problem, as well as those related to a correct therapeutic approach.

Combined Modality Therapy↗
PubMed1989

Carcinoma of the vulva (1981-1985): analysis of a radio-surgical approach.

Carcinoma of the vulva has recently been the subject of renewed interest of gynecologists and oncologists. That which is commonly defined as the "choice" treatment is a radical vulvectomy with bilateral inguinal lymphadenectomy and, in the case of lymph node metastases, pelvic lymphadenectomy. The usefulness of the pelvic dissection has, however, been disputed and various Authors have proposed an alternative treatment consisting of radical vulvectomy and inguinal lymphadenectomy with external radiotherapy on the inguinal and pelvic lymph nodes, in the case of N+. The present report describes 56 patients with vulvar carcinoma treated at the Regina Elena National Cancer Institute of Rome, 42 of whom were submitted to radical surgery. In 14 of these patients, metastases in the inguinal lymph nodes were found: 10 were submitted to radiotherapy (with TCT or low voltage linear accelerator for a total of 50 Gy over a 5-week period), while the remaining 4 were not treated with any further therapy. Although the survey includes only a limited number of patients, the results obtained certainly favor radio-surgical treatment, also considering data reported in international literature regarding pelvic lymphadenectomy. The actuarial 5-year survival rates for the patients treated with surgery plus radiotherapy is 50% and the recurrence rate is 20%. Although a greater experience is certainly warranted in this field, we believe it may be stated (also on the basis of a recent study conducted by the Gynecologic Oncology Group) that radiotherapy represents a valid alternative to pelvic dissection if an adequate patients selection is made.

Adult↗
PubMedDate not supplied

Fine needle aspiration of a warthin-like thyroid tumor. Report of a case with differential diagnostic criteria vs. other lymphocyte-rich thyroid lesions.

BACKGROUND: Warthin-like papillary carcinoma of the thyroid (WLT), a recently described entity, should be included among lymphocyterich lesions of the thyroid. The diffuse sclerosing variant of papillary carcinoma (DSV), the oxyphilic variant of Hashimoto thyroiditis (OHT) and primary lymphoplasmacytic lymphoma (PLT), the FNA appearances of which have many similarities, belong to the same category. CASE REPORT: A case of WLT occurred in a 31-year-old female, who was admitted with a 1.5-cm, nodular lesion of the thyroid; fine needle aspiration (FNA) yielded a diagnosis of papillary carcinoma. Histologic examination revealed the characteristic picture of WLT, with papillae lined with large, oxyphilic thyreocytes, with nuclear pseudoinclusions and grooves filled with lymphocytes, mostly mature plasma cells. The FNA picture of WLT was compared with those of the other lymphocyticrich lesions of the thyroid--DSV, OHT and PLT. CONCLUSION: The differences between these forms provide diagnostic criteria that could be useful for the preoperative management of patients affected by suspicious, inflammation like thyroid lesions.

Adult↗
PubMedDate not supplied

[The non-recurrent inferior laryngeal nerve. Surgical experience].

During the performance of 1018 thyroid operations, 1497 recurrent laryngeal nerves were identified and exposed. Of the 773 visualized nerves on the right side, 2 were found to be non recurrent (0.26%). This abnormality may represent a pitfall during thyroidectomy even for very experienced thyroid surgeons. We emphasize that the exposure and preservation of this vital structure is the standard of care and an essential component of routine dissection in thyroid surgery.

Humans↗
PubMedDate not supplied

Carotid endarterectomy. Which diagnostic imaging technique is suitable for the indication and planning of surgery?

Based on data of recent literature, the most suitable preoperative diagnostic approach to cerebrovascular insufficiency, is evaluated. Correct indications for carotid endarterectomy in symptomatic and asymptomatic carotid stenoses are related to the degree of stenosis. This is also the most important predictive factor of stroke ipsilateral to the stenosis. Arteriography is being used selectively, while color Doppler US is the examination of first choice, combined with MR-angiography, cerebral CT and transcranial Doppler in most cases of carotid stenosis to be treated with surgery. An accurate and reliable preoperative diagnostic evaluation, together with an impeccable surgical procedure represents the indispensable prerequisite to maintain the mortality and complications within those strict limits that make a prophylactic intervention as carotid endarterectomy, advantagious to the patient.

Carotid Stenosis↗