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Biomedical subjects

E Brunetti

Publications and source records attributed to E Brunetti.

At least 37 records · Page 2Linked to original sources
PubMed1998

Novel clinical approaches in monoclonal antibody-based management in colorectal cancer patients: radioimmunoguided surgery and antigen augmentation.

Surgery, the most effective treatment for colon and rectal cancer, is based on empirical knowledge of the patterns of tumor spread, gross findings at laparotomy, and histologic confirmation of tumor-free margins. In spite of the many technical improvements in surgery, there has not been a significant change in cure rates for colon and rectal cancers. In fact, one-half of affected patients will not survive 5 years. It is in this arena of treatment for primary colon and rectal cancer patients that radioimmunoguided surgery (RIGS) technology may provide the most benefit. RIGS is an intraoperative procedure for detection of carcinoma lesions that are targeted with a radiolabeled monoclonal antibody (MAb) to provide the surgeon with immediate intraoperative definition of tumor margins and identification of occult disease. To optimize this technique, our studies were designed to increase tumor uptake by higher affinity CC-49 (a second-generation MAb) and to increase tumor antigen expression using biological response modifiers (BRMs). The ability of BRMs, such as interferons (IFNs), to enhance the expression of tumor-associated antigens, may play an important role in an adjuvant setting for MAb-based treatment. Preclinical and clinical data provided evidence for the use of IFN as an adjuvant to enhance MAb-targeting of human carcinoma lesions. A combination protocol with IFN and RIGS is ongoing at our institution.

Antibodies, Monoclonal↗
PubMed1997

Use of PAIR in human cystic echinococcosis.

The authors report their experience with ultrasound (US)-guided percutaneous treatment of hydatid abdominal cysts (mainly hepatic). From November 1987 to January 1996 in Italy and in Kenya 231 cysts in 163 patients were treated with a technique called PAIR (puncture, aspiration, injection, re-aspiration), using 95% ethanol as a scolecide agent according to a routine protocol. In Kakuma, Turkana (Kenya) 141 cysts in 85 patients were treated with a simplified protocol and a portable US machine. No anaphylactic shock or peritoneal dissemination was observed. One failure was observed due to the proximity of the parasitic cyst to the gallbladder, resulting in a fistula between the two cavities; this complication was resolved by surgery. A few minor complications were observed. In all the other cases detachment of the germinal membrane and subsequent reduction in size was observed, with a more or less complete solidification of the cyst and reduction of serology titers. Only one cyst recurred after 4 years and was treated again by PAIR. Long-term results indicate that in type I, II and III cysts, according to the Gharbi classification, PAIR is a first-choice method for treatment of liver hydatid cysts, especially in developing countries.

Adolescent↗
PubMed1992

Outcome of hepatic amebic abscesses managed with three different therapeutic strategies.

Three different approaches to hepatic abscesses due to Entamoeba histolytica were compared in 51 patients. The three modes of therapy utilized were: medical therapy with nitroimidazoles (N = 11 patients), open surgical drainage (N = 9 patients), and percutaneous drainage using ultrasound guidance followed by intralesional nitroimidazole administration (N = 31 patients). The results with each form of therapy were assessed clinically and by abdominal ultrasound. Patients receiving combined US-guided drainage and intralesional chemotherapy experienced a faster and overall better clinical response, which was confirmed also by sonographic follow-up of the hepatic lesions. This better response was associated with faster resolution, fewer relapses, and less residual hepatic scarring than either with medical therapy alone or open surgical drainage combined with medical therapy.

Adult↗
PubMed1991

Familial Alzheimer's disease. Evidences for clinical and genetic heterogeneity.

We report the genealogical, clinical and molecular genetic findings of a new family with autosomal dominant early-onset Alzheimer's disease (FAD) discovered in Torino (Italy). Up to now, the pedigree comprises 1500 members, distributed in 8 generations. 22 patients affected with Alzheimer's disease have been identified. The clinical course of the disease was fairly uniform in all the patients. An high incidence of myoclonic jerks and epileptic seizures was found. Molecular genetic studies showed the presence of positive but nonsignificant lod scores between chromosome 21 anonymous DNA markers and the disease. The data obtained from the Torino family were computed together with those of additional 47 pedigrees, with both early-onset and late-onset Alzheimer's disease. A predisposing locus for the disease was found on the pericentromeric region of chromosome 21 only in early-onset FAD pedigrees.

Adult↗
PubMed1990

A new therapeutic approach for hydatid liver cysts. Aspiration and alcohol injection under sonographic guidance.

The treatment of hydatid disease is still rather difficult; surgery is not always feasible, and there are no definite methods to evaluate the outcome of medical treatment. Although percutaneous needle aspiration of hydatid cysts has been discouraged because of potential complications, e.g., anaphylactic shock or spreading of daughter cysts, these risks have never been quantified. Therefore, it was decided to treat hydatid liver cysts by aspiration and alcohol injection under sonographic guidance using 95% sterile ethanol. Five patients are reported who were treated by this procedure without complications or relapses during a follow-up period ranging from 10-26 mo.

Adult↗
PubMed1990

Effects of chronic ethanol treatment on alpha-MSH concentrations in rat brain and pituitary.

Male Sprague-Dawley rats were chronically treated with a liquid diet containing 6.5% (v/v) ethanol or equicaloric sucrose. Rats were killed after 21 days of treatment. alpha-MSH-like immunoreactivity was measured in the intermediate lobe of the pituitary gland and in several brain regions. Chronic ethanol treatment significantly reduced alpha-MSH-like immunoreactivity in the pituitary gland; in the arcuate nucleus of the hypothalamus and in the substantia nigra. The results of this study confirm the earlier findings that chronic ethanol treatment reduces POMC biosynthesis in the pituitary gland and in the central nervous system.

Alcoholism↗
PubMed1990

Parasitologic findings in percutaneous drainage of human hydatid liver cysts.

Percutaneous drainage under ultrasonographic guidance was carried out on 12 patients with liver cysts and 1 with an abdominal cyst. In 8 the cyst was proved to be of hydatid origin by means of direct detection of parasites in the aspirated fluid. In these individuals a 95% ethanol solution was subsequently introduced into the cystic cavity and slowly removed over 30 min. Direct observation, staining for viability assessment, and in vitro isolation attempts were done both before and after the injection of the alcoholic solution, thus making possible the immediate evaluation of the protoscolicidal properties of the solution used. The procedure seems to be therapeutically successful, safe, and feasible.

Adult↗
PubMed1990

Ultrasound findings in retroperitoneal lymphangiomyomatosis.

A 44-year old female patient with pulmonary lymphangiomyomatosis was examined by standard abdominal sonography. A wide involvement of the retroperitoneal lymph nodes and vessels was found. The relevant sonographic features were enlarged lymph nodes, and multiple anechoic structures, irregular in shape, thin-walled, with intraluminal septa. The findings, which resembled active cysts or liquid-filled bowels, were diagnosed as multiple ectasic lymphatic vessels.

Adult↗
PubMed1989

Ultrasonographic and microbiological diagnosis of mycetic liver abscesses in patients with AIDS.

A rare case of multiple mycetic abscesses in a patient with AIDS is reported: the diagnosis was suspected after an ultrasound (US) examination and was obtained with US guided percutaneous puncture. The US appearance and differential diagnosis of mycetic liver abscesses are discussed and the increasing role of US and US guided percutaneous puncture in the screening of these patients is stressed.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Munchausen syndrome by proxy: a new complication of central venous catheterization.

A recent case of supposed gastrointestinal (GI) bleeding in a small child underscored the difficulty inherent in making the diagnosis of Munchausen syndrome by proxy. In this case, an indwelling Broviac central venous catheter was used by the mother to withdraw blood which was then arranged to feign blood loss from her son's upper and lower GI tract. Despite the mother/perpetrator's displaying the classic personality traits of Munchausen syndrome by proxy, diagnosis was not made for many weeks.

Adult↗
PubMed1985

In utero sonographic diagnosis of semilobar holoprosencephaly.

Since its early diagnostic application in the study of pregnancy, ultrasonography (US) has been widely employed in the detection of fetal malformations. Head abnormalities, recognized through the evaluation of brain and skull structures, accounted for the majority of these observations. We report here on a case of holoprosencephaly, a rare malformation (incidence is around 1/16,000 live births according to Roach et al. [1975]) diagnosed and monitored up to delivery by multiple US examinations.

Adult↗