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Biomedical subjects

D Crippa

Publications and source records attributed to D Crippa.

At least 19 recordsLinked to original sources

Adjuvant therapy with the pineal hormone melatonin in patients with lymph node relapse due to malignant melanoma.

Several experimental studies have shown that melatonin has an oncostatic action, either by stimulating host antitumor immune defenses or by directly inhibiting the growth of some cancer histotypes, including melanoma. Our previous clinical studies demonstrated that melatonin may induce stabilization of the disease in untreatable metastatic solid tumor patients, and these results have been confirmed by others, at least in patients with metastatic melanoma. On the contrary, at present there are no data related to the possible efficacy of melatonin as an adjuvant endocrine therapy. This study was performed to investigate the impact of melatonin therapy on the disease-free survival (DFS) in melanoma patients surgically treated for regional node recurrence. The study included 30 node-relapsed melanoma patients, who were randomized to receive no treatment or adjuvant therapy of melatonin (20 mg/day orally in the evening) every day until disease progression. After a median follow up of 31 months, the percent of DFS was significantly higher in melatonin-treated individuals than in controls. The DFS curve was also significantly longer in melatonin group than in controls. No melatonin-related toxicity was observed. This preliminary study suggests that an adjuvant endocrine therapy with melatonin may be effective in preventing disease progression in node-relapsed melanoma patients.

Adult

[Cutaneous angiogenesis associated with vulvar epidermoid carcinoma].

A case of cutaneous angiogenesis, probably induced by tumour angiogenic factors (TAF), is described. The patient, a 39-year-old female, affected by a vulvar squamous cell carcinoma, developed some erythematoangiomatous lesions on the lower abdominal quadrants, contiguously to the tumour. Histopathologically, the lesions were characterized by vascular neoformation in the superficial dermis and a slight lymphohistiocytic lesions resolved after the polychemotherapy which preceded enlarged vulvectomy. This supports the hypothesis of a close correlation between neoangiogenesis and TAF.

Adult

[Trigeminal neurotrophic ulcer. A case report].

A case of a 49-year-old woman affected by wide ulcerations on the face which have been caused by the patient herself, as she has admitted, is reported. The lesions were strictly limited to the area of innervation of the first and second branch of the trigeminal nerve. The patient presented parasthesias and analgesia in the trigeminal area as the consequence of a neurosurgical operation. She also suffered from important psychosis. All these elements enable us to diagnose "trigeminal trophic ulcers". The pathogenesis of this syndrome is discussed.

Cranial Nerve Diseases

Cutaneous leishmaniasis. Treatment with itraconazole.

The chemotherapy of leishmaniasis is still far from satisfactory. Itraconazole, one of the most recent azole antifungal agents, appears to be well tolerated in man. Two patients with cutaneous leishmaniasis (Leishmania tropica), contracted in Saudi Arabia, were treated orally for 2 months with itraconazole (100 mg/d). Both recovered without side effects or abnormalities in their main biologic parameters.

Adult

Rolipram versus imipramine in inpatients with major, "minor" or atypical depressive disorder: a double-blind double-dummy study aimed at testing a novel therapeutic approach.

Unlike conventional antidepressants, rolipram stimulates both the presynaptic as well as the postsynaptic component of monoaminergic transmission. Several double-blind comparative trials are on the way to assess the clinical efficacy and safety of this novel compound. The present study was a randomized double-blind double-dummy comparison with imipramine in inpatients with major, "minor" and atypical depressions (DSM III). Results show no relevant differences between rolipram and imipramine regarding efficacy and safety.

Adolescent

[Granuloma anulare perforans: 2 clinically different forms].

Two different forms of granuloma annulare perforans are described. One form, which particularly affects young people, is characterized by small nodular lesions with central umbilication and a monomorphic clinical picture. These lesions can persist for many years, but spontaneous remission often occurs. The second form affects older patients. The clinical picture is polymorphic, consisting of dull red papules, umbilicated papules, pustular lesions and small atrophic scars. This form is resistant to a variety of therapies and does not heal spontaneously.

Aged

Excessive daytime sleepiness: a 1-year study in an unselected inpatient population.

A prospective epidemiological investigation of excessive daytime sleepiness (EDS) was carried out in an unselected inpatient population admitted to a general hospital during a 1-year period. The study comprised 2518 patients, 1347 female and 1171 male, aged 6-92 years (mean, 55.2). On the basis of histories and clinical and polysomnographic data, EDS was found in 28 cases (1.11%). Of these, 25 (0.99%; 18 female and 7 male; mean age, 61.3) had sleep apnea syndromes (SAS) with predominantly obstructive apnea. Two patients (0.07%; one female and one male; mean age, 65.5) had idiopathic CNS hypersomnia, and one male patient (0.03%) aged 48 years had a combination of narcolepsy and SAS. Differences and agreements of our findings with previous literature data are discussed. The present study shows that in an unselected inpatient population, EDS is a relatively common sleep disorder, usually found in mild to moderate forms. Because it is not severe, it disturbs only relatively domestic activities of elderly retired patients or others who do not work outside the home, and is often masked by other troubles. For these reasons, EDS in the aging population may pass unnoticed in epidemiological studies based only on data from sleep disorder centers.

Adolescent