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Biomedical subjects

D Melloni

Publications and source records attributed to D Melloni.

17 recordsLinked to original sources
PubMed2006

Preliminary report of a multicentric study on environmental risk factors in Ta-T1 transitional cell carcinoma of the bladder. A study from Gruppo Studi Tumori Urologici Foundation.

OBJECTIVE: The distribution of potential environmental risk factors among patients affected by superficial transitional cell carcinoma of the bladder (TCCB) has been analyzed. METHODS: Patients affected by superficial TCCB underwent TUR and early intravesical chemotherapy. Detailed data about age, sex, residence, employment, active and passive cigarette smoking, water resource and hair dye use were centralized. Analysis has been conducted on 474 patients affected by Ta-T1 G1-2 TCCB at medium risk for recurrence. Patients with primary single Ta G1-2, Tis or T1G3 tumors were excluded from the present analysis. RESULTS: Over 80% of the patients lived in urban areas, 22% were employed in industries presumed at risk for bladder cancer, 8% used hair dye and 75% were smokers. Bottled water was the only water resource in 42% of the patients. Employment in industry at risk (p = 0.01) and cigarette smoking (p = 0.04) resulted in being statistically related to tumor multiplicity. Moreover, the period of cigarette smoking was significantly longer in patients with recurrent tumors (p = 0.026). The municipal water supply represented the main water source in never-smokers (p = 0.01) rather than in smokers and in patients harboring T1 rather than Ta tumors (p = 0.03). CONCLUSIONS: Employment in industry at risk and cigarette smoking resulted in being related to tumor multiplicity. The length of exposure to cigarette smoking was related to the natural history of the tumor. A drinkable water source emerged as a risk factor in absence of cigarette smoking.

Adult↗
PubMed2004

Lithiasic obstructive uropathy. Hydronephrosis characterization by magnetic resonance pyelography.

OBJECTIVES: The purpose of this study was to evaluate the role of magnetic resonance (MR) pyelography in patients affected by hydronephrosis due to ureteric stones, in order to identify a pyonephrotic condition. MATERIALS AND METHODS: In the last 3 years, 315 patients, who had originally been investigated by ultrasonography, were evaluated with MR pyelography in order to define the etiology of obstruction. In 67 patients hydronephrosis was referred as caused by lithiasis. RESULTS: MR pyelography not only confirmed urinary tract dilatation in all patients, but also identified grade and site of obstruction, both in acute dilatation (25 patients) and in chronic obstructions (42 patients). In 7 patients, MR pyelography documented pyonephrosis that was obviously confirmed by nephrostomic drainage. CONCLUSION: MR pyelography, made with ultrafast breath-hold sequences, has a great value in identifying hydronephrosis in patients with ureteric stones. Furthermore, it provides the chance to identify pyonephrosis requiring an immediate drainage of the kidney before major complications develop.

Adult↗
PubMed2003

Biological aggressiveness evaluation in prostate carcinomas:immunohistochemical analysis of PCNA and p53 in a series of Gleason 6 (3+3) adenocarcinomas.

We selected 63 prostate tumors with Gleason's grade 6 (3+3), commonly showing both tubular and cribrous patterns. We compared in both patterns the expression of two of the most used biologic markers: PCNA and p53, with the aim to verify the validity of the Gleason's grading system to compare the morphologic grade with biologic aggressiveness and prognostic value. We did not find any statistical difference in the protein immunopositivity, indicating that both patterns could have identical biologic behaviour; then we confirmed the validity of Gleason's system for considering both tubular and cribrous patterns as an intermediate grade of tumoral differentiation. Moreover, we found a linear relationship between the increase of PCNA and the accumulation of mutated p53; this datum could confirm the hypothesis that p53 mutation is a late event in prostate carcinogenesis.

Adenocarcinoma↗
PubMed2001

Relationship of flow rate with symptoms, quality of life and other clinical parameters in patients with LUTS suggestive of BPH.

AIM: The uroflowmetry data of a selected number of patients who took part to the QUIBUS study (366 traces selected after quality control by a central panel of reviewer) were evaluated for their relationships with age, prostate volume, and IPSS and ICS-BPH scores. Waiting time, flow time, voided volume, maximum flow rate (Q(max)) and average flow rate (Q(ave)) were the flow variables considered for analysis. Only measurements with total voided volume exceeding 100 ml were included. RESULTS: An increasing percentage of subjects with voided volume <200 ml was observed over 65 years of age. Age did not affect neither Q(ave) nor Q(max )(p = n.s. at correlation analysis). In particular, Q(max)was <15 ml/s in about 70% of patients independently of age. Prostate enlargement was inversely associated with voided volume, Q(max) and Q(ave), showing a worsening of urinary function for increasing values of prostate volume Q(max) was negatively correlated with IPSS total score and with most single items with the exception of two storage symptoms such as repeated urination and nocturia). Accordingly, Q(max) was inversely associated with the total score ICS-BPH for voiding symptoms to a higher extent (r = -0.31, p < 0.01) than with the one for storage symptoms (r = -0.22, p < 0.01). Flow variables were inversely correlated with IPSS-QoL. CONCLUSION: Uroflowmetry and IPSS, although not allowing a definitive diagnosis of obstruction, may nonetheless satisfy the clinical need of a rapid, easy and accurate tool for the noninvasive screening of LUTS patients.

Adult↗
PubMed2001

PSA and second-line therapy of hormone refractory prostate carcinoma.

The aim of the present study was to correlate PSA response with subjective response (bone pain and performance status), in patients treated for hormone refractory carcinoma of the prostate. Twenty-four patients were introduced into the study. Median PSA was 198 ng/ml. Symptom score, performance status and PSA were monitored monthly for 3 months and then 3-monthly. Sixteen patients (66%) showed a PSA response (median value 10 ng/ml). In 8 patients (33%) PSA was <4 ng/ml. Eight patients (33%) only had a subjective response. However, 75% of the patients with a PSA value <4 ng/ml had a subjective improvement. On the other hand, subjective response was 25% only in patients in whom PSA value decreased to <50% of the initial value but >4 ng/ml. In conclusion, PSA response is not always related to subjective improvement and does not always implicate a beneficial effect of the therapy for the patient.

Adenocarcinoma↗
PubMed1997

A new device for prevention of postoperative haematoma in the surgery of varicose veins.

The objective of this article is the presentation of a new device, simple, easy to use, at low cost, for the prevention of postoperative haematoma following surgery of varicose veins of the lower limbs. It consists in a two-part device that functions as an elastic and pneumatic bandage, that wraps thigh and leg, with the knee articulation free and that is placed immediately before the stripping of the saphenous vein when all the surgical wounds are closed, except the supramalleolar one. While the head of the stripper is pulled, the device is inflated by air with a compression of 40-50 mmHg and the last surgical wound is sutured. Pneumatic compression is held for 24-36 hours, allowing the patients to walk and, in the meantime, to control the colour and the temperature of the foot. The advantages of this device are: easy use and low costs; compression on the area of the saphenous vein and of the main collaterals; uniform but moderate pressure on all the limb circumference.

Equipment Design↗
PubMed1989

Interactive computerized morphometric analysis for the differential diagnosis between dysplasia and well differentiated adenocarcinoma of the prostate.

To distinguish prostatic dysplasia (or adenosis) from well differentiated adenocarcinoma on transrectal needle biopsy, a morphometric study was conducted on 20 cases of adenosis and 20 cases of well differentiated adenocarcinoma of the prostate. About 100 cells for each patient were analyzed by means of a computerized image analyzer, and mean nuclear diameter, mean nuclear area, mean form factor and number of cells in eight classes of nuclear diameter were studied. The best predictors of malignancy (evaluated by means of Receiver Operating Characteristics curves) were mean nuclear area greater than 28 mu2, presence of more than 5% of cells with nuclear diameter greater than 6.15 mu, and mean nuclear diameter greater than 5 mu. Using these diagnostic criteria the probability of malignancy for a positive specimen rises from 14% (pre-test) to 75% (post-test).

Adenocarcinoma↗
PubMed1989

Pharmacokinetic study on adenomatous prostate tissue concentrations of cefoperazone. Clinical efficacy and patient tolerance of intramuscular cefoperazone treatment of chronic bacterial prostatitis.

Cephalosporins do not reach active therapeutical concentrations in the prostatic tissue in patients suffering from chronic bacterial prostatitis. Cefoperazone is an exception. Its efficacy in the treatment of chronic bacterial prostatitis in 20 patients was studied and the concentrations, obtained after intramuscular administration, evaluated in patients who underwent transurethral operation due to prostatic hypertrophy (in 14 patients). The cefoperazone concentrations in the prostate have been evaluated 60, 90 and in some cases 120 min after the administration of the drug and compared to those obtained in serum. The clinical cure has been obtained in 16 patients. The average drug concentration in the prostate after 60 min was 22.8 +/- 13.6 versus 39.8 +/- 20.0 micrograms/ml in serum; 90 min after administration the average concentration in the prostate was 23.2 +/- 14.1 versus 35.7 +/- 18.1 micrograms/ml in serum. The correlation was significant both at 60 min (r = 64, p less than 0.05) and at 90 min (r = 64, p less than 0.05).

Cefoperazone↗
PubMed1982

Kelfiprim, a new sulpha-trimethoprim combination, versus cotrimoxazole, in the treatment of urinary tract infections: a multicentre, double-blind trial.

A new combination of trimethoprim with a sulphonamide, named Kelfiprim, differs from cotrimoxazole in that: a) the sulpha drug is sulphamethopyrazine instead of sulphamethoxazole; b) the trimethoprim to sulpha ratio is 5:4 instead of 1:5; c) the presence of a long-acting sulphonamide allows the administration of a daily dose of one capsule, following an initial loading dose of two capsules; d) a reduced amount of trimethoprim is given, as compared to cotrimoxazole, without any decrease of efficacy. Kelfiprim [KP] was compared to cotrimoxazole [Co] in a multicentre double blind trial. Sixty four patients suffering from acute and chronic infections of the upper and lower urinary tract entered the study. Urine sterilisation and clinical improvement without relapses showed no differences from the two treatment groups. Tolerance was excellent except in two patients, one treated with KP and the other treated with Co, who showed a transient exanthema.

Clinical Trials as Topic↗
PubMedDate not supplied

[Short-term and long-term surgical prophylaxis with pefloxacin].

In the present study the efficacy and safety of pefloxacin (400 mg/5 ml vial) intravenously administrated for surgical prophylaxis was assessed. Nine hundred and fifty-two patients were treated (599 M, 343 F), with a mean age of 57.9 years +/- 18.6 SD, and in all cases surgical prophylaxis was carried out according to the following scheme: short-term with 2 vials (800 mg) 1 h before the operation, repeated at 12 and 24 hours after the operation; long-term 2 vials (800 mg) 1 h before the operation repeated at 12 and 24 hours after the operation and followed by 1 vial every 12 h for other 2 days. The choice between the two schemes was conditioned by the type of operation and by the basic conditions of the patient. Pefloxacin was seen to be effective in preventing the onset of post-surgical infections (97%), also maintaining the clinical parameters considered within normal limits. Safety was also highly satisfactory, since only 22 (2.3%) cases of side effects occurred, particularly involving the gastro-intestinal system. Thus, in conclusion, the validity of pefloxacin in surgical prophylaxis, with special emphasis on its efficacy in elderly and compromised patients is asserted.

Adult↗