[Correlations between the increment of maternal weight and neonatal mortality in a population of low-weight newborn infants].
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Body Weight↗
Biomedical subjects
F Colombo
Publications and source records attributed to F Colombo.
[Biopsy and stereotaxic radiotherapy of cerebral gliomas].
The Authors report their experience on a series of 125 patients that underwent stereotactic biopsy. The procedure has proved reliable and almost risk -free. The diagnosis obtained from the bioptic specimen by smear technique-cytological examination and by paraffin embedding-histological examination are compared. Neuropathologic data were also checked by the examination of the tumor bulk in cases that underwent surgical removal or autoptic verification. The preliminary results obtained in 8 patients with the new technique of external stereotactic irradiation by means of a linear accelerator are also shown.
Biopsy↗
Preparation and evaluation of [99mTc]DEPE as a cardiac perfusion agent.
Technetium-99m labeled bis(1,2-diethylphosphino)ethane was evaluated as a cardiac perfusion agent in mice, dogs and normal human volunteers. The agent produced as a single cationic compound was prepared by a simple kit type method and had a rapid myocardial uptake in animals. The cardiac uptake of the agent in dogs averaged 4.6% of administered dose and delineated left and right ventricles by in vivo imaging. In dogs with experimental myocardial infarction, the agent was distributed according to the regional myocardial blood flow, had excellent correlation with myocardial distribution of 85Sr microspheres (r = 0.96, 0.93)] and 201Tl (r = 0.91 and 0.83), and enabled us to detect perfusion defects by in vivo scintigraphy. The agent, however, failed to have a useful degree of cardiac uptake in humans.
Animals↗
Somatosensory-evoked potentials after mesencephalic tractotomy for pain syndromes. Neuroradiologic and clinical correlations.
Eight patients affected by intractable pain underwent stereotactic mesencephalic tractotomy. Recordings of somatosensory-evoked potentials were made before and after the surgical procedure. Localization and size of the obtained lesion were controlled by computed tomography scans. Clinical result was compared with modification of postoperative somatosensory-evoked potentials and with the appearance of the lesion in the computed tomography scans.
Aged↗
The microsurgical drainage of the varicocele.
A new technique for surgical treatment of primary and recurrent varicocele is proposed. The technique consists of direct anastomosis of two or three dilated veins of the pampiniform plexus with the great saphenous vein. A connection between a high venous pressure region and a lower pressure region is established. Twenty-five patients were operated on, 7 with recurrent varicocele and 18 with primary varicocele. The immediate and long-term results (6 year follow-up) have always been good.
Drainage↗
A new dynamometric technique to measure and locate endocranial structures. Preliminary report.
An apparatus for measuring and recording the resistance to penetration of endocranial tissue has been planned and built. The probe carrier, driven by a constant-speed electric motor, is fitted onto a stereotactic head frame which is used to guide the tool to the intended target. The displacement and resistance encountered when the tool penetrates intracranial structures are measured and recorded on an x-y recorder. Preliminary tests performed on calf brain specimens have documented that the apparatus can measure the different consistencies of normal cerebral tissue and suggest a new technique for morphological investigations based on the mechanical consistency of normal and pathological organic tissue. Moreover, the hypothesis of a plastic deformation in cerebral tissue has been confirmed, in that the same apparatus permits one to measure the displacement of tissues caused by the advancement of the surgical tool.
Biopsy↗
High-dose neuroleptics: uncontrolled clinical practice confirms controlled clinical trials.
The strategy of high-dose intramuscular haloperidol as routinely applied in a general hospital psychiatric ward to 74 successive patients, 33 of whom stayed only up to seven days, and a further 34 up to 15 days, led to a complete recovery in only six, and complete lack of change in 23. Adverse reactions were recorded in 42, severe enough to stop treatment in eight; there were three deaths. In view of this risk-benefit analysis, systematic application of this high dose strategy to get a more rapid turnover of patients is unjustified.
Adolescent↗
Spontaneous intracerebral hematomas: a new proposal about the usefulness and limits of surgical treatment.
We analyzed the volume of 132 spontaneous supratentorial intracerebral hematomas calculated with computed tomographic (CT) scans and related it to the clinical condition of the patients on admission and to the outcome at their discharge from the hospital (1 to 3 months after the ictus). Fifty patients were operated on, and 82 received only medical treatment. In evaluating outcome, we were more interested in survival than its quality. The main problem is the evaluation and treatment of the many patients who are comatose upon admission (about half of the patients). We concluded that surgical treatment by evacuation of the hematoma increases the percentage of survival of comatose patients with a hematoma volume between 26 and 85 ml.
Cerebral Hemorrhage↗
A multi-centre trial comparing a sulfamethopyrazine/trimethoprim combination with co-trimoxazole in respiratory tract infections.
A double-blind, multi-centre trial was carried out in 72 patients with acute or chronic infections of the lower respiratory tract to compare the efficacy and tolerance of a sulfamethopyrazine (200 mg)/trimethoprim (250 mg) combination with that of the established combination co-trimoxazole (400 mg sulphamethoxazole plus 80 mg trimethoprim). Patients received treatment for 10 days either with 2 capsules of co-trimoxazole twice daily or in the newer combination group with 2 capsules on Day 1 but then only 1 capsule daily for the remainder of the treatment period. The results of clinical, bacteriological and functional tests showed an excellent or good response in over 90% of patients in each group. There was no statistically significant difference in effectiveness of treatment with the once-daily sulfamethopyrazine/trimethoprim regime compared with co-trimoxazole given twice daily, and both treatments were well tolerated, with only a few mild side-effects, mainly gastro-intestinal ones, being reported.
Adolescent↗
[Stereotaxic irradiation with a linear accelerator].
At least two fundamental requirements must subsist for every stereotaxic radiotherapy treatment: 1) a capacity to administer extremely high doses of radiation to small areas which have been precisely defined in three dimensions; 2) the presence of a steep gradient between adjacent isodose curves so that damage to the tissues close to the target may be reduced to the minimum. The authors have built a special stereotaxic device for the fixing of the head of the patient (together with the chosen intracranial target), once the indispensable neuroradiological evaluations and bioptic controls have been effected, at the isocenter of a linear accelerator (Varian Clinac 4). Once the dimensions of the collimator have been chosen in accordance with the volume and the three dimensional conformation of the target and the dose to be administered has been decided upon in accordance with the histological nature of the lesion, both the linear accelerator and the patient are rotated about the isocenter of the therapy unit. It this way it is possible to reach extremely high dosages with very steep isodose gradients, centered exclusively upon the target ("gamma knife"). The procedure employed is described in full. The dosimetric evaluations which preceded the use of the set-up in clinical practice are illustrated as well. The advantages that this technique offers when compared with interstitial brachytherapy and/or Leksell's radiosurgical procedures are stressed. The described procedure, which is entirely bloodless and thus applicable also to high vascularized lesions, has so far been used in a limited series of cases.
Brain Diseases↗
Zidometacin: pharmacokinetic study on oral absorption.
Zidometacin is a new nonsteroidal antiinflammatory agent structurally related to indomethacin. Pharmacological studies show its favourable activity/ulcerogenicity ratio in comparison to indomethacin. Preliminary clinical data indicate a good analgesic effect after a single dose and an improvement of functional conditions of the joint after short-term therapy. Pharmacokinetic parameters and bioavailability of the drug were evaluated in the present study after the administration of a single oral dose. Nine healthy volunteers without impairment of hepatic and renal function were selected. According to a 3 X 3 replicated latin square they received a 100 mg capsule, a 200 mg capsule and a 100 mg solution (sodium salt). After various time intervals, blood samples and urines were collected. Plasma and urine levels were evaluated by means of a specific high-performance liquid chromatography method. No difference between plasma levels of capsules (100 mg) and solution (100 mg) was observed. Capsules showed a dose/level relationship between 100 mg and 200 mg. Mean half-lives (+/- s.d.) of capsules (100 and 200 mg) and solution were respectively 3.5 +/- 2.33, 2.8 +/- 1.22, 4.4 +/- 2.96 h. The 0-48 h recovery of total zidometacin (free + conjugated) was 27.4% (100 mg capsule), 20.7% (200 mg capsule) and 24.6% (solution). Only a small amount of zidometacin was excreted unchanged. The drug is well absorbed and its bioavailability appears satisfactory.
Administration, Oral↗
Lung cancer care in general hospitals.
Diagnostic procedure, therapeutic care and degree of follow-up delivered to 1692 lung cancer patients over 2 years (1978-79) in 31 Italian hospitals were reviewed. The data show marked deficiencies in the various indicators analysed: staging by standard methods was recorded only in 13% of patients; reliable histocytologic classification in 54% of patients. A group of commonly accepted protocols was adopted as first-line therapy only in 49% of treated cases; 19% of patients were regularly followed according to standard programs, whereas 49% had been dropped without any information in the charts. Better performance, although not satisfactory, was found in hospitals with oncologic facilities and wards compared to centers without "ad hoc" organizations. The discussion focussed on the limits of organizational measures and efforts to determine widespread improvement in care for a disease such as lung cancer for which real therapeutic gains are still hard to achieve.
Adult↗
[Indications and limitations of digital arteriography].
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Angiography↗
Rebleeding of an angiographically healed aneurysm.
An angiographically "healed" aneurysm, which rebled, is reported. Although the angiographic control was negative, the patient was operated upon, and the aneurysmal sac was patent.
Cerebral Angiography↗
Care of cancer patients in thirty-one Italian general hospitals. Methodological aspects and general findings.
A large sample of cancer patients was reviewed over a two-year period (1978-1979) in 31 general and community hospitals representing five Italian regions, differing in terms of health care organization. Two thousand four hundred and six patients had breast cancer, 1692 lung cancer, 303 non-Hodgkin's lymphomas, 277 ovarian cancer and 235 Hodgkin's lymphoma. Relevant information was collected from medical records through specific pre-standardized and tested forms. The paper discusses the results obtained with respect to (a) general descriptive data of the population; (b) completeness and reliability of recorded data (e.g. staging, histological classification, therapy); and (c) accuracy and completeness of the follow-up. Consistency of the information obtained on selected items with published series of patients suggests that this methodology is worth a wider testing as a simple, inexpensive tool for routinely monitoring the care of cancer patients and the impact on it of organizational and educational interventions.
Adolescent↗
Ten-year survival in 290 patients with endometrial cancer: prognostic factors and therapeutic approach.
Between 1970 and 1976, 290 patients with endometrial cancer were treated at the 1st Obstetrics and Gynecology Clinic of the University of Milan. The median age was 62 years. Surgery was completed in 262 (90.3%) patients. Abdominal hysterectomy was used in 158 (70.9%) stage I and 40 (71.4%) stage II/III) patients; vaginal hysterectomy in 55 (24.7%) stage I and nine (16.1%) stage II/III patients. Resection of the upper vagina was performed in 168 patients. Postoperative external beam radiotherapy was used in stage II/III patients and in 44 (19.7%) stage I high-risk patients. Ten-year survival, determined by the life-table method, was 84.8% in stage I (223 patients), 53.4% in stage II (37 patients), 64.4% in stage III (19 patients), and 9.1% in stage IV (11 patients). Factors associated with poorer prognosis were: late age at diagnosis (P less than 0.001); deep myometrial invasion (P less than 0.001); poorly differentiated histological grade (P = 0.11); lack of resection of the upper vagina (P = 0.13). The role and importance of surgery is discussed, with special emphasis on the selective use of the vaginal route in aged, obese and medically high-risk patients.
Adult↗
Human exposure to heavy metals. Rare earth pneumoconiosis in occupational workers.
A male subject exposed for many years to rare earth (RE)-containing fumes and dusts emitted from carbon arc lamps in photoengraving laboratories was investigated to rule out RE pneumoconiosis. While chest x-ray films showed a severe pulmonary fibrosis, clinical analysis showed obvious high RE concentrations in the pulmonary and lymph node biopsy specimens compared with the corresponding tissues of 11 unexposed subjects. In addition to other elements, levels of thorium (Th), which is generally present as an impurity of RE compounds, were also determined to estimate the radiation dose which may be involved in inducing pneumoconiosis. The results show that the levels of Th are more than two orders of magnitude lower than the maximum permissible concentration for occupational exposure to natural 232Th, suggesting that the long-term accumulation of RE in the lungs played a role in the pathogenesis of the observed pulmonary fibrosis of the worker.
Biopsy↗
Cognitive outcome and early indices of severity of head injury.
Neuropsychological outcome of 100 patients with severe head injuries is correlated with their clinical condition on admission. The aim of this paper is to estimate the reliability of several early indices of brain damage severity in formulating a prognosis. Both the Glasgow Coma Scale and the neurological syndrome involved appeared to be highly reliable in this respect. The duration of coma and of posttraumatic amnesia was not as significant. Since these two parameters were assessed when reviewing the cases, they have to be considered only as retrospective judgments. The findings emphasized the importance of reflex ocular motility and the value of recording electroencephalographic (EEG) activity, particularly EEG sleep patterns. The relationship between rapid eye movement sleep impairment and cognitive defects was highly significant. Analysis of surgical observations demonstrated that purely compressive expanding lesions were not as harmful as parenchymal damage. Of paramount importance was the time lapse between injury and surgery, since secondary lesions may develop and affect cerebral areas that are involved both in sleep organization and in memory functions.
Brain Injuries↗