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Biomedical subjects

D Battistutta

Publications and source records attributed to D Battistutta.

54 records · Page 3Linked to original sources
PubMed1992

Invasive squamous cell carcinoma of the vulva: behaviour and results in the light of changing management regimens. A review of clinicohistological features predictive of regional lymph node involvement and local recurrence.

Ninety-nine patients with carcinoma of the vulva were referred to the Gynaecologic Oncology Unit, Royal Brisbane Hospital, over 10 years. Ninety of these patients had a squamous cell carcinoma (SCC). They were assessed by the 1969 FIGO clinical staging. Each stage was related to nodal involvement, size, depth, histological grade, lymphvascular space involvement, perineural permeation and multifocal disease site. The operability rate was 85%. Treatment was individualized in line with recent philosophies for more conservative surgery where appropriate. Mortality was 2.6%. Five-year survival of surgically treated patients was 60.3%; node negative patients 100%, and node positive patients 25.2%. After adjustment for stage and size, the only other independent statistically significant feature was perineural penetration. Local recurrence was more likely with increased stage and size, unclear margins and multifocal involvement. It is important to note that medically unfit patients who had vulvectomy alone and who later developed positive nodes had 100% mortality. This group of patients significantly decreases survival rates, confirming the importance of carrying out inguinofemoral lymphadenectomy at the time of initial surgery. Morbidity was decreased by conservative surgery. Lymphoedema remains the most common chronic complication. No significant difference was shown in local recurrence between different types of surgery, wide excision, hemivulvectomy, simple vulvectomy or radical vulvectomy (22%), confirming the safety of the more conservative approach of recent years.

Adult↗
PubMed1992

Effect of dialyzer reprocessing with Renalin on serum beta-2-microglobulin and complement activation in hemodialysis patients.

The peracetic acid-based sterilant Renalin is increasingly being used for reprocessing hemodialyzers. In order to evaluate the effects of reprocessing on beta 2-microglobulin (beta 2M) kinetics and complement activation in chronic hemodialysis patients, we compared 4 dialyzer membranes on 1st, 2nd and 4th use of the membrane. Dialysis with new cuprammonium rayon dialyzers (0.8 m2) for 4 h resulted in a nonsignificant increase in serum beta 2M concentrations of 10.7% (corrected for changes in extracellular volume) and significant generation of the complement component C3a des Arg. On reuse, minimal changes in serum beta 2M levels were noted and complement activation was absent. Dialysis with new cellulose acetate (CA, 1.5 m2), polyacrylonitrile (AN69 HF, 1.6 m2) or polymethylmethacrylate (PMMA, 1.6 m2) membranes resulted in significant decreases in serum beta 2M levels (19.5, 31.7 and 50.8%, respectively). Reprocessing had negligible effects on the removal of beta 2M by CA and AN69, but by the 4th use halved the effectiveness of PMMA. Reprocessing reduced the significant generation of C3a des Arg observed with new CA and PMMA membranes. We conclude that, except for PMMA, Renalin reprocessing has minor effects on the ability of the membranes to remove beta 2M and improves the biocompatibility of all membranes studied.

Acetic Acid↗
PubMed1992

Human antibody responses to epitopes on the Plasmodium falciparum gametocyte antigen PFS 48/45 and their relationship to infectivity of gametocyte carriers.

Antibodies in human sera recognizing epitopes I, IIa, III, and IV on the Plasmodium falciparum gametocyte antigen Pfs 48/45 have been investigated by competitive enzyme-linked immunosorbent assay. More than one-third of the residents of three villages in Madang, Papua New Guinea responded to epitopes I, IIa and III, with little variation by village or with time. There was a bimodal distribution of positive sera by age, with the highest proportion of responders in the 5-9- and greater than 20-year-old age groups. The data suggest a lower prevalence of antibodies against epitopes IIa and III in P. falciparum gametocyte carriers than in non-carriers. Enhancement of binding of monoclonal antibodies to epitopes IIa and III was also observed more frequently with sera from gametocyte carriers. Sera from gametocyte carriers in Papua New Guinea and Thailand, whose infectivity to mosquitoes had been tested, were used to examine the relationship between recognition of particular epitopes and infectivity. There was a significant association between lack of infectivity of P. falciparum gametocyte carriers and recognition of epitope IIa on Pfs 48/45 by antibodies in their sera.

Adolescent↗
PubMed1991

Prognostic significance of monoclonal antibody 3H-1 reactivity with squamous-cell head-and-neck cancers.

We report the reactivity of a novel murine IgM monoclonal antibody (MAb), 3H-1, in formalin-fixed tissue from a series of 44 patients with squamous-cell cancers (SCCs) of the upper aerodigestive tract. The antigen detected by 3H-1 MAb is not expressed in simple squamous epithelia and only rarely in non-squamous malignancies. The following staining patterns were found to be associated with a progressively unfavourable prognosis: membranous, diffuse cytoplasmic and focal cytoplasmic/nil staining. There were no statistically-significant associations between focal cytoplasmic/nil staining and traditionally used prognostic parameters such as tumour size, nodal involvement or pathologic grade. However, multivariate analyses demonstrated that focal or nil staining was a significant independent prognostic factor for survival (p less than 0.001) and was the only significant prognostic factor for relapse (p less than 0.001). The converse applied to tumours with predominantly membranous staining (p = 0.004). 3H-1 MAb, with the advantage of relying on the pattern rather than the intensity of staining, makes it possible to identify different cellular phenotypic sub-populations more accurately than by conventional means, and may ultimately improve our understanding of the mechanisms underlying transformation from a benign or proliferative state to a malignant one.

Antibodies, Monoclonal↗
PubMed1991

Prognostic importance of cellular DNA content in head-and-neck squamous-cell cancers. A comparison of retrospective and prospective series.

Flow cytometric DNA-ploidy measurements were performed on formalin-fixed tumour specimens from 172 patients with squamous-cell cancers (SCCs) of the head and neck region. One hundred and two samples were chosen retrospectively and a further 70 consecutive patients were analysed prospectively in order to assess the prognostic significance of DNA ploidy and DNA index (DI). There were no statistically significant differences between retrospective and prospective groups in regard to age, sex, TNM stage, ploidy or DI. Sixty-seven percent of patients were aneuploid (65% retrospective; 71% prospective). The proportion of aneuploid tumours was significantly higher among poorly differentiated tumours. Survival analysis using Cox multivariate regression modelling revealed that DNA aneuploidy and increasing DI were significant independent prognostic factors for both relapse-free and overall survival. The relapse and death rates among aneuploid subjects were approximately 3 times as high as those for diploid subjects. Patients with a DI greater than 2.11 (hypertetraploidy) experienced a 6.6-fold higher death rate than diploid subjects. These results provide strong support for the incorporation of DNA ploidy profiles into the clinical management of patients with head and neck cancer.

Adult↗
PubMed1991

Iatrogenic influences on the heritability of childhood tonsillectomy: cohort differences in twin concordance.

In 1980-82, a mailed questionnaire was completed by 3,810 pairs of adult twins enrolled on the Australian NH&MRC Twin Register. Twins were asked whether they had had their tonsils out and, if so, at what age. The sample was divided into four birth cohorts of approximately equal size, and only childhood tonsillectomy (to the age of 18) was considered. The prevalence of tonsillectomy differed markedly between cohorts, being highest in those born in the 1940s and early 1950s. Within each cohort, the prevalence was very similar in MZ and DZ twins, yet concordance was much higher in MZ twins, indicating the importance of genetic factors in predisposition to tonsillectomy. However, the proportions of variance in liability due to genetic and shared environmental factors differed markedly between cohorts. In the 1950s, when tonsillectomy was fashionable, shared environment accounted for 60% of variance and genetic factors for only 29%. However, by the early 1960s, when tonsillectomy was going out of fashion, heritability was up to 0.82 and shared environment accounted for only 10% of variance. Our results illustrate, once again, that heritability is not a constant, but depends on the precise characteristics of the population and the time at which it is studied.

Australia↗
PubMed1990

Incidence and determinants of skin cancer in a high-risk Australian population.

In a Queensland community, we surveyed the incidence of basal-cell carcinoma (BCC) and squamous-cell carcinoma (SCC), and associated risk factors. In December, 1986, 2,095 residents were examined by dermatologists for skin cancer. Of these, 1,770 further participated in a follow-up postal survey in December, 1987, regarding all skin cancers in the preceding 2 years, and 87 reported being treated for skin cancer in the 2-year period between December 1985 and November 1987. The estimated annual incidence rates of non-melanoma skin cancer in men and women aged 20-69 years were 2,389/100,000 and 1,908/100,000 respectively, with an overall ratio of BCC cases to SCC cases of 4.5 to one. While both tumour types occurred more commonly in fair-complexioned people, the risk associated with high sun exposure was greater for SCC than for BCC. Clinical signs of solar skin damage, especially the number of solar keratoses on the face, were the strongest predictors of both types of skin cancer.

Adult↗
PubMed1990

Evening primrose oil and treatment of premenstrual syndrome.

The therapeutic effectiveness of evening primrose oil (Efamol, Vita-Glow) in the relief of 10 symptoms associated with premenstrual syndrome (PMS) as well as menstrual symptoms was studied in 38 women. The prospective trial was randomised, double-blind and placebo-controlled and was crossed-over after three cycles. Although the results showed an improvement in symptoms of PMS during the trial, no significant differences in the scoring between the active and placebo groups were found over six cycles. No "carry-over" effect of active medication was observed; the beneficial effect on all symptoms (psychological, fluid retention, breast) was rapid, the scores decreasing in the first cycle but increasing slightly at the change-over period after the third cycle, irrespective of whether the active or placebo medication was next given. These findings indicate that the improvement experienced by these women with moderate PMS was solely a placebo effect.

Adult↗
PubMed1990

Analysis of the sequences flanking the translational start sites of Plasmodium falciparum.

The 5' and 3' regions adjacent to the initiation codon in 22 Plasmodium falciparum sequences were examined. A 5' consensus sequence (AAAA/ATG) was found. Although P. falciparum non-translated DNA is A-rich, A occurred significantly more frequently in the 4 positions preceding the initiation ATG than in adjacent non-translated DNA, suggesting that this consensus sequence has functional significance in the initiation of translation. This region has similarities with the equivalent sequences in yeast and Drosophila but differs markedly from that in vertebrates. No significant bias in nucleotide frequencies was found 3' to the initiation codon.

Animals↗
PubMed1990

The prevalence of naturally acquired multiple infections of Wuchereria bancrofti and human malarias in anophelines.

Malaria and filaria infection rates were determined for anopheline mosquitoes collected whilst biting and resting in village houses in Papua New Guinea. The number of anophelines infected with both parasites was greater than expected from the infection rates of each parasite and this difference was significant in resting collections. The excess of multiply infected mosquitoes is probably a result of a vector population composed of individuals with differing numbers of opportunities to become infected. Malaria-positive Anopheles punctulatus from resting catches had a significantly greater number of Stage 3 Wuchereria bancrofti larvae than malaria-negative mosquitoes. However, multiply infected mosquitoes appear to suffer greater mortality than non-infected or singly infected mosquitoes when the filarial worm reaches the third stage. Any potential increase in transmission resulting from multiple infections is thereby offset by a greater mortality rate in these mosquitoes.

Animals↗
PubMed1990

Genetics of asthma and hay fever in Australian twins.

The occurrence of self-reported asthma/wheezing and hay fever among 3,808 pairs of twins from the Australian National Health and Medical Research Council Twin Registry was examined for evidence of genetic transmission by path analytic methods. The cumulative prevalence of asthma or wheezing was 13.2% and of hay fever, 32%. There were significant correlations in liability to reported disease among twins, and these were higher in monozygotic twins (MZ) (r = 0.65) than in dizygotic twins (DZ) (r = 0.25), and in male MZ twins (r = 0.75) compared with female MZ twins (r = 0.60). Analysis under the assumptions of the classic twin model suggested that there were genetic factors common to asthma and hay fever, with a correlation in genetic liability to the traits of 0.52 for men and 0.65 for women. These genes acted substantially in a nonadditive fashion in men but not in women. As the genetic correlation was significantly less than unity, this implied additional genetic factors influencing either or both diseases individually. The estimated heritability of these diseases was 60 to 70% in this population. Environmental causes of both diseases also were correlated (r = 0.53 for men and 0.33 for women). Cigarette smoking was only weakly associated with wheezing.

Adult↗
PubMed1990

Variations in malaria transmission rates are not related to anopheline survivorship per feeding cycle.

Anopheline survivorship, vectorial capacity, and mosquito infection probability estimates from mosquito infection rates were determined 4 times in 1 year in a Papua New Guinea village. Estimates of survivorship over the length of the extrinsic incubation period differed significantly during the year. However, survivorship per feeding cycle, individual mosquito vectorial capacity, and mosquito infection probability did not vary significantly. Estimates of these parameters were then compared to estimates of survivorship, individual vectorial capacity, and mosquito infection probability in mosquito populations in other villages in the study area. Since survivorship per feeding cycle did not vary significantly among the mosquito populations in these villages, changes in malaria transmission potential can be better gauged from estimates of survivorship over the length of the extrinsic incubation period. However, as measurements of relative inoculation rates are easier to perform and have been related to parasite prevalences in children in this area, estimates of inoculation rates are a preferred option for estimating malaria transmission in the Madang area of Papua New Guinea.

Animals↗
PubMed1989

Analysis of human T cell response to two Plasmodium falciparum merozoite surface antigens.

Eight novel human T cell epitopes were identified within the two major merozoite surface antigens (MSA1 and MSA2) of Plasmodium falciparum using synthetic peptides. All except one of the peptides conformed structurally to an amphipathic alpha helix and three out of the four MSA1 peptides also contained sequences containing the Rothbard motif. Peptide MSA2/2, which fitted none of these criteria, was recognized by our donors to a similar degree as the other peptides. This peptide also contains a B cell epitope. Proliferative responses were obtained in both immune and nonimmune donors, however, the number of responses in the immune donor group was significantly higher. There was no correlation between the level of proliferation and antibody titers to these antigens. No peptides were preferentially recognized in association with specific HLA class II antigens.

Animals↗
PubMed1989

Differential antibody responses to Plasmodium falciparum and P. vivax circumsporozoite proteins in a human population.

Papua New Guineans exposed to hyperendemic malaria in the Madang area showed different antibody responses to Plasmodium falciparum and Plasmodium vivax sporozoites despite comparable entomological inoculation rates. Although there was a significant trend of increasing prevalence of anti-P. falciparum circumsporozoite (CS) protein immunoglobulin G (IgG) with age, there was no significant increase in the antibody units of IgG recognizing P. falciparum CS proteins. Antibodies recognizing P. vivax CS proteins steadily increased in prevalence and antibody units with age. Significant trends of increasing prevalence of antibody responders (both IgG and IgM) with increasing splenic enlargement were found in the younger age groups for P. falciparum CS proteins but not for P. vivax CS proteins. When antibody responders were analyzed by quartiles, there was a trend of increasing antibody response with age against P. vivax CS peptide, but not for P. falciparum CS protein. There was no evidence for increasing protection against blood-stage infections with increasing antibody levels for either P. falciparum or P. vivax. Neither were any significant relationships found between entomological inoculation rates and either CS antibody prevalence or concentration among the villages studied.

Adolescent↗
PubMed1988

Codon usage in Plasmodium falciparum.

The codon frequencies used in 7874 codons from 17 sequences of Plasmodium falciparum have been examined. The frequency distribution is markedly biased. A and C occur with similar frequency in all positions but G is predominantly in the first base and T is predominantly in the last position. This information can be used to predict the coding strand and reading frame of P. falciparum genes.

Animals↗
PubMed1986

A comparison of costs and data quality of three health survey methods: mail, telephone and personal home interview.

Three survey modes--a self-administered mailed questionnaire, a telephone interview, and a home interview--were assessed for survey costs, adequacy of completion, test-retest reliability, validity of responses to medical questions and estimates of morbidity. Costs per household for each mode were $A42.75, $A74.33, and $71.89, respectively. Item omission was confined virtually to the mail mode and averaged 5.5% over 84 questions assessed, while telephone and home interview modes averaged 0.4% and 0.2%, respectively. "Don't knows" were virtually absent for all questions except those about precise details (names, places, etc.) of events occurring often 10-15 years before the survey; no mode differences were observed. The mail mode produced less reliable responses to questions about environmental exposure to hazardous chemicals or activities when considered question-by-question, but differences were not significant among modes when all questions were grouped. Reliability was high to medical questions and no mode differences were observed. Medical conditions which would require a medical diagnosis for subjects to be able to report them were more reliably answered than conditions described in broad or lay terms. Validity of answers to medical questions varied across modes and types of questions; underreporting of medical conditions was highest in the mail mode and was lowest for conditions requiring a diagnosis. Overreporting was lowest in the mail mode and highest for conditions requiring a diagnostic opinion.

2,4,5-Trichlorophenoxyacetic Acid↗
PubMedDate not supplied

Predictors of bereavement outcome for family carers of cancer patients.

AIMS: The psychological outcome of family carers after bereavement is an important issue in evaluating palliative care services. Palliative care services have the potential to provide preventive psychosocial intervention to family carers prior to bereavement, but are faced with the need to identify those who may have greatest risk of adverse outcome. This prospective study examines predictors of psychological outcome for family carers of cancer patients following bereavement based on factors identified at referral to a palliative care agency. METHODS: Cancer patients and their family carer were consecutively recruited and assessed on a range of clinical and psychological measures at referral to a palliative home care service in a metropolitan centre (Time 1). Carers were again assessed following the death of the patient, on average at 4 months post-bereavement (Time 2), using measures of bereavement symptoms and psychological morbidity. RESULTS: 178 carers were assessed on both occasions. The chief predictors of carer psychological symptoms and severity of grief at follow-up were psychological symptom scores at the time of referral (Time 1). Factors also measured at Time 1 were significant predictors of symptoms and grief scores at Time 2: greater number of adverse life events, carer's coping responses, past bereavement and separation experiences, the relationship with the patient, and greater severity of patient's illness at the time of palliative care referral. CONCLUSIONS: The findings indicate clinical risk factors for adverse short-term bereavement outcome that can be identified in family carers during palliative care treatment, that have implications for identifying the psychological needs of carers, and that form a potential basis for interventions to enhance the psychological outcome for family carers.

Adaptation, Psychological↗