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D Ugolini

Publications and source records attributed to D Ugolini.

35 records · Page 2Linked to original sources

Tamoxifen in the treatment of metastatic malignant melanoma: still a controversy? (Review).

This review attempts to summarize the available preclinical and clinical evidence supporting the inclusion of tamoxifen (TAM) in the treatment of malignant melanoma, in the attempt to identify what role, if any, the antiestrogen could have in the present and future therapeutic approach to this disease. Emphasis has been given to the biological basis of the potential TAM mechanisms of action, as well as to the rational basis underlying the study design of the reported clinical experiences. Results to date show that TAM has no useful activity as a single agent in melanoma patients, most published response rates reaching less than 10%. A still controversial question is the inclusion of the antiestrogen in different active chemotherapy regimens, since clinical investigations on the role of TAM in combination therapy of advanced melanoma have produced inconclusive results. While several early trials suggested that TAM may improve the response rates when combined with different cytotoxic agents, the majority of subsequent reports, including recent randomized studies, did not show a significant benefit stemming from TAM addition to various single-agent or multi-agent combinations. Only one controlled trial showed a significant improvement in both response rate and survival for patients receiving dacarbazine plus TAM, an effect primarily noted in women, and confirmatory studies have not been reported. From a biological standpoint, why the activity of this poorly effective single-agent is potentiated when given in combination with some cytotoxic agents is not clearly understood, although preclinical and clinical experiences support a possible synergistic effect of TAM combined with cisplatin, particularly when the former is added at high doses. Of major interest is a body of experimental studies producing confirmatory data that induction of apoptosis, probably through the inhibition of protein kinase C, as well angiogenesis inhibition, at least in part mediated by TGF-beta stimulation, are alternative ways through which TAM suppresses tumor cell growth, independently of the expression of estrogen receptors. These findings also provide a model and rationale for combining TAM with agents which are able to modify cell biology in melanoma. The investigation on TAM-containing biological combinations appears to be a promising avenue to be explored in the near future. To this end, clinical research should incorporate biological studies to allow the selection of subgroups of patients who are most likely to benefit from TAM-based treatment.

Antineoplastic Agents, Hormonal↗

Electronic biomedical journals: how they appear and what they offer.

This study, prompted by a number of articles presaging the imminent demise of biomedical journals due to the rise of their electronic spread, analysed 54 Web sites of the journals included in the Oncology section of the Science Citation Index, Journal Citation Reports (1994) and the sites of 10 other leading digitised biomedical journals. The aim was to determine quantitative and qualitative differences in terms of information content existing between the two media. The analysis confirmed that there are limits to the information contained in the scientific journals currently on the Internet and upholds the authors' conclusion that, in the oncology field, the printed journal will continue to have an important role for most individual users for some time.

Computer Communication Networks↗

Assessing research productivity in an oncology research institute: the role of the documentation center.

An evaluation method used to assess the quality of research productivity and to provide priorities for budget allocation purposes is presented. This method, developed by a working group of the National Institute for Research on Cancer (IST), Genoa, Italy, is based on the partitioning of categories of the Science Citation Index and Journal Citation Reports (SCI-JCR) into deciles, which normalizes journal impact factors in order to gauge the quality of the productivity. A second parameter related to the number of staff of each institute department co-authoring a given paper has been introduced in order to guide departmental budget allocations. The information scientists of the IST Documentation Center who participated in the working group played a pivotal role in developing the computerized database of publications, providing and analyzing data, supplying and evaluating literature on the topic, and placing international bibliographic databases at the working group's disposal.

Documentation↗

[Features and evolution of postoperative pain in patients undergoing thoracotomy].

We examined in this perspective study 30 patients (15 males and 15 females) who undergone classic thoracotomy for lung or mediastinal diseases, without postoperative complications. Intensity and different qualitative components of postoperative pain have been evaluated in the 1st, 3rd, 5th, the day after last pleural drainage removal and 2 months after the operation. All patients answered a schedule adherent to Questionario Italiano del Dolore (QUID). Pain became less intense chiefly with drainage removal with the same time trend for both sex (parallel curves). Pain is probably stronger in women. From a qualitative point of view, the sensorial component is the same in both sexes. Affective and evaluative component is greater in women: in other words, women realize more than men the painful stimulus and are more troubled. A computerized analysis of answers to a questionnaire like QUID or, better, its evolution, may be helpful for a more effective pharmacological choice between pure analgesics, sedative analgesics and ataractic drugs.

Analgesics↗

["N2" carcinoma of the lung. Therapeutic considerations].

The follow-up of 240 N2 lung cancer cases operated in Thoracic and Cardiovascular Surgery Department of Florence is examined. The analysis is performed in compliance with global survival, "T", histology, therapeutic choices. Global survival is 81% after 6 months, 60% after 1 year, 37% after 2 years, 26% after 3 years, 23% after 4 years, 23% after 5 years. Significative difference on survival does not exist between principal histologic types (squamous, adenocarcinoma, adenosquamous). Raising the "T" survival decreases, but only for adenocarcinoma. Different therapeutic options (only surgery, surgery+radiotherapy, surgery+chemotherapy, surgery+radio and chemotherapy) do not influence the survival in a way statistically significative. From the literature, any certainty about radiotherapy and chemotherapy associated to surgery for N2 lung cancer treatment does not exist at the moment. Thus radical surgery is essential.

Adenocarcinoma↗

[Surgical staging of pulmonary carcinoma. Probability of error].

234 patients with lung cancer and operated in Thoracic and Cardiovascular Surgery Department of Careggi Hospital in Florence have been evaluated in order to examine surgical staging accuracy in comparison with pathological staging. There is a statistically significative difference between surgical and pathological staging as a datum point. Surgeon is inclined to over-estimate the lymph-nodes involvement and the primitive tumor extension. It is important to bear in mind this bent whenever decisions of surgical strategy have to be taken.

Diagnostic Errors↗

Chemical hazard evaluation: the use of factual health and safety databanks.

The usefulness of factual health and safety databanks is discussed in this paper. Four databanks have been selected for this study: HSDB (Hazardous Substances Data Bank), ECDIN (Environmental Chemicals Data Information Network), RTECS (Registry of the Toxic Effects of Chemical Substances) and CCRIS (Chemical Carcinogenesis Research Information). The quality of the information available in the databanks considered was examined for five different chemical compounds and the completeness of the information available was carried out by an analysis of carcinogenic and mutagenic data.

Animals↗

The PDQ (Physician Data Query), the cancer database, in oncological clinical practice.

The above illustrates the fact that a physician interested in consulting the PDQ database must dedicate a certain amount of time to an analytical review of the database. It is difficult to determine how much time is required to acquire a sufficient level of control because there are many variables affecting the learning time: experience in using computerized systems, cultural background, personal inclination, etc. However, a certain amount of caution and humility should be exercised whenever a physician approaches a database of this type for the first time, in order to avoid the mistake of dangerously underestimating the nature of the problem. On the other hand, the physician's specific competence and professionalism will not be questioned at all, since they are fundamental to obtain productive search results. If, indeed, the above discussion focussed heavily on the most closely documental aspect of the problem, it should not be forgotten that the contents of the database can be fully understood only by experts who are used to encountering certain terms and procedures on a daily basis. In fact, when a physician turns to a documentation center for a PDQ research, the physician's assistance is always requested in order pair clinical and documental competence. It is this second skill that the physician must acquire to become totally independent.

Databases, Factual↗

Stage-dependent induction of prenatal tumors in mice by the Kirsten and Moloney strains of murine sarcoma viruses.

The Moloney (MoMSV) and Kirsten (KiMSV) strains of murine sarcoma viruses are known to induce mesenchymal sarcomas upon infection of newborn rodents. To determine their activity in mouse embryos, 11- to 15-day-pregnant CD-1 mice were laparotomized, and the single implants were inoculated into the abdominal portion of the embryonal body with an average of 15 and 1500 focus-forming particles/g of body weight of the MoMSV and KiMSV viruses, respectively. Another group of less than 1-day-old pups was given a comparable amount of either virus. Tumors appeared in the young within the first few weeks of life with incidences and histological types dependent on the gestational day and the viral strain inoculated. Mixed mesenchymal sarcomas at or near the site of inoculation and vascular tumors of the brain were by far the most frequent neoplasms observed in the newborn. With MoMSV there was an increased incidence of sarcomas with advancing age at treatment, being 0% at 11 days of pregnancy and 96% in newborn (P for trend, less than 0.025). By contrast, KiMSV caused an incidence of sarcomas below 20% throughout (P for trend, greater than 0.05). Brain tumors were identified in the several MoMSV and KiMSV groups, with a peak value of 43% following the inoculation of both viruses into 13- and 15-day-old embryos, respectively. While the total incidence of these tumors was significantly different from controls, no positive trend by day of treatment was found among the MoMSV and KiMSV viruses (P less than 0.05). The tumors were mainly capillary angiomas, but a few cavernous angiomas were also detected. In addition, eight pups which were given injections of both viruses at developmental Days 11 to 13 had tumors of the choroid plexus. In many instances, newborn pups were affected by multiple vascular abnormalities of the brain, including capillary telangiectases and multiple hemorrhagic areas. No such lesions nor tumors at any site were found among the control animals. The present results are important not only because of the evidence that Swiss embryos respond selectively to the carcinogenic effects by murine sarcoma viruses, but also because they offer the opportunity to dissect directly in vivo the mechanisms underlying the stage-related sensitivity of prenatal mice to oncogenic retroviruses.

Animals↗

Information oncologic tools produced by the U.S. National Cancer Institute: how much are they known and used? Results of an enquiry in Italy.

A survey was conducted among specialized users in order to establish the level of knowledge and diffusion of four informative tools: Cancerlit, PDQ, Clinprot, Cancergram. A questionnaire was distributed to 975 graduate researchers working in four national cancer research institutes in the north (2), center (1) and south (1) of Italy, as well as to the students of the Postgraduate School of Oncology (Oncology 2nd) of the "La Sapienza" University of Rome. Respondents were 486 (49.8%): only 167 (34.4%) declared to know Cancerlit, 56 (11.5%) PDQ, 10 (2%) Clinprot and 39 (8%) Cancergrams. Moreover, there is a time gap of nearly 6 years between the availability on-line of these tools and the information of its existence by the users. Most of the respondents were in favor of inserting courses on the use of information tools into the University curriculum and of training in the use of the tools.

Databases, Factual↗

Sustaining Oncology Studies--SOS: information and support for training, research and exploitation in cancer and related biomedical disciplines.

This paper outlines the development of the Sustaining Oncology Studies Information Resources (SOS Europe), a multimedia World Wide Web (WWW) prototype providing support to experimental and clinical cancer researchers, general practitioners, industry personnel, and university students in the field of oncology in Europe and Italy. The system utilizes applications developed for the WWW and is designed in the most easily understandable approaches possible. The prototype now structures oncology-related information available on the Internet and also places resources maintained locally at users' disposal. The system utilizes a WWW browser as a design platform and HTML to build its Home and subpages and to create hyperlinks to internal and external resources.

Computer Communication Networks↗

Frequency of musculoskeletal conditions among patients referred to Italian tertiary rheumatological centers.

OBJECTIVE: To describe the occurrence of different rheumatic diseases and to examine the characteristics of patients referred to six Italian rheumatological units. To compare these data with those from other countries. METHODS: Six Italian rheumatological tertiary referral centers participated in the study. Diagnoses of in- and outpatients aged over 16 years were classified according to the International Classification of Diseases, ninth revision. RESULTS: Three thousand, five hundred and thirty-seven patients with mean age 56 +/- 14.8 years, of which 2604 (73.6%) were women, were studied. Inflammatory joint and spine diseases were diagnosed in 40.4%, connective tissue diseases in 14.4%, degenerative joint and spine diseases in 21.4%, soft tissue rheumatisms in 18.5%, and metabolic bone diseases in 5.3%. There was a significant difference among centers in the frequency of most diagnoses: non-academic centers cared for more patients with arthritis and connective tissue diseases and for less patients with degenerative diseases, soft tissue rheumatisms and metabolic bone diseases. Connective tissue diseases were constantly seen more often in Italian centers, whereas soft tissue rheumatisms were seen more often abroad. CONCLUSION: Our data emphasize the great variability of the diagnostic case-mix in different centers from the same country, an observation that raises some concerns of the results of descriptive multicenter studies. Studies on the breakdown of diagnoses made in rheumatological centers could be helpful to determine the burden of rheumatic diseases on the health system, and for the planning of health interventions by both the national rheumatological societies and health authorities.

Adolescent↗