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Biomedical subjects

F Ricci

Publications and source records attributed to F Ricci.

At least 73 records · Page 4Linked to original sources
PubMed1998

Study on Ki-67 immunoreactivity as a prognostic indicator in patients with advanced gastric cancer.

BACKGROUND: Cell proliferation characteristics may reflect the aggressiveness of gastric tumors and their eventual prognosis. The aim of this study was to evaluate whether the proliferative activities determined by the antibody Ki-67 could be used as a prognostic predictor in patients affected by advanced gastric cancer. METHODS: The prognostic significance of proliferative activity was investigated in 56 patients who underwent curative gastrectomy (R0) for advanced gastric cancer using the monoclonal antibody Ki-67. The patients were divided into three groups according to the Ki-67 labeling index of the tumors: < 10% (18 cases), 10-40% (21 cases) and > 40% (17 cases). The Cox regression model was used to evaluate the prognostic significance of the Ki-67 index controlling for age, gender, histology, depth of tumor invasion and node metastasis. RESULTS: There was no significant relationship between the Ki-67 index and wall invasion (P = 0.80) or nodal status (P = 0.73). The cumulative 3-year survival rates (95% Cl) were 61.0% (35.3-79.2%) in patients with Ki-67 index < 10%, 52.4% (29.7-70.9%) with Ki-67 index 10-40% and 52.9% (27.6-73.0%) with Ki-67 index > 40% and the differences were not statistically significant (P = 0.93). Also in multivariate analysis the proliferative activity did not independently affect survival (P = 0.98). An interaction between Ki-67 index and age was found and Ki-67 index > 40% was significantly associated with a poor prognosis in patients over 68 years old (P = 0.004). CONCLUSION: Our study indicated that the proliferative activity in gastric cancer, determined with the monoclonal antibody Ki-67, does not influence the survival except in elderly patients (> or = 68 years old).

Age Factors↗
PubMed1998

Iris vascular changes in newborns of diabetic mothers.

Routine ophthalmic examinations of 600 full-term neonates, including 54 born to mothers with insulin-dependent diabetes mellitus and 12 whose mothers had developed gestational diabetes, revealed significant tortuosity and dilatation of the iris vessels in over half of the infants born to diabetic mothers. Ninety percent of the newborns in the diabetic group presented hypoplasia of the iris stroma and pupil dynamics were altered in 85%. The vessel changes resolved spontaneously within 2 weeks after birth. These changes, which have also been observed in cocaine-intoxicated newborns, should raise the suspicion of adverse vascular effects in the fetus caused by maternal diabetes.

Adult↗
PubMed1998

Electro-oculography in pigment dispersion syndrome.

Clinical data and the common embryological origin of the pigment epithelium of the iris and retinal pigment epithelium suggest that the latter may be involved in the pigment dispersion syndrome (PDS). In our study functional changes of the retinal pigment epithelium were evaluated by electro-oculography in 10 PDS patients, 10 patients with chronic open-angle glaucoma (COAG) and 10 normal subjects. The mean dark-trough latency and Arden ratio for the PDS group were significantly lower than those of the COAG and control groups. Analysis of the Arden ratios based on the Kruskall-Wallis test revealed that 30% of the PDS values were subnormal with respect to the control group mean -1 SD. These results indicate primary involvement of the retinal pigment epithelium in PDS.

Adult↗
PubMed1998

Flow cytometry immunophenotyping and polymerase chain reaction-site-specific primers genotyping for HPA-1 alloantigens in an Italian blood donor population.

BACKGROUND AND OBJECTIVES: There is increasing interest in the development of rapid and reliable techniques for human platelet alloantigen (HPA) typing. This study investigates the reliability of flow cytometry for large-scale immunophenotyping of platelet alloantigens. MATERIALS AND METHODS: We used flow cytometry and polymerase chain reaction-site-specific primer (PCR-SSP) for the characterization of the human platelet antigen 1 (HPA-1) mosaic in blood donors. RESULTS: By using specific alloantisera and immunofluorescence labelling 9 (2.6%) out of 351 samples were HPA-1a-negative. To confirm this antigenic phenotype, all of the latter samples were submitted to PCR-SSP analysis, showing an HPA1-b/b genomic pattern. In HPA-1a-positive donors, flow cytometry was unable to distinguish HPA-1a/b heterozygous from HPA-1a/a homozygous subjects who were clearly identified by genotyping. CONCLUSIONS: Flow cytometry is a valuable tool for large-scale screening to identify HPA-1a-negative persons, whereas genotyping is the assay of choice for zygosity testing, antenatal diagnosis, and for thrombocytopenic alloimmunized patients.

Adult↗
PubMed1998

Detection of abdominal adhesions in laparoscopic surgery. A controlled study of 130 cases.

The risk of visceral injury during laparoscopy occurs mainly during the creation of the pneumoperitoneum and the insertion of the first trocar and is substantially greater in patients with a previous history of laparotomic surgery or peritonitis, owing to the possible presence of abdominal wall adhesions. In this study we assessed the results of preoperative ultrasonography of the parietal wall for the diagnosis of peritoneal adhesions, through the detection of two signs unrelated to one another, for the purpose of minimizing the number of false-negative results. Ultrasonography of the parietal wall was performed preoperatively in 130 patients who had previously undergone laparotomy. The ultrasound results were transcribed in the form of a map of the abdominal wall and checked during laparoscopy. The overall diagnostic accuracy was 88.5%, the specificity was 31.8%, and the sensitivity was 100%. The hazardous laparoscopic maneuvers were performed in adhesion-free areas in all cases, and there were no cases of complications due to visceral injury.

Abdomen↗
PubMed1998

Alloimmunization against human platelet antigen 2 (HPA2) in a series of multi-transfused beta-thalassemia patients.

In our study we investigated the presence of anti-human platelet antigen (HPA) alloantibodies in a series of 10 beta-thalassemia major patients submitted for more than 10 years to periodic blood transfusions (every 2-3 weeks). We found that 2 out of the 10 patients developed anti-HPA2a + HPA1b and anti-HPA2b antibodies. Our results highlight that HPA alloimmunization in multitransfused patients is a real possibility.

Adult↗
PubMed1997

Minimally invasive treatment of acute biliary pancreatitis.

BACKGROUND: Stones of the common bile duct are the most important factor in acute pancreatitis (AP). Endolaparoscopic surgery plays a well-recognized role in the treatment of this pathology. METHODS: From January 1992 to December 1995 we observed 62 cases of acute biliary pancreatitis (ABP). In 57 cases (= 93.4%) we proposed a minimally invasive treatment, based on performance of endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic sphincterotomy (ES) and then of laparoscopic cholecystectomy (LC). RESULTS: ERCP was attempted in emergency in 40/57 cases and successfully done in 34 cases. An ES was performed in all but two cases. In 51 patients we performed LC. The overall morbidity was 8. 9% with no mortality. CONCLUSIONS: In the case of ABP early treatment can achieve the restoration of patency of the papilla, reducing the risk of associated cholangitis and the development of pancreatic necrosis. The cholecystectomy prevents the risk of relapse of ABP.

Acute Disease↗
PubMed1997

Glycosaminoglycans delay the progression of nephropathy in NIDDM.

OBJECTIVE: To determine the effect of oral administration of glycosaminoglycans on metabolic control and albumin excretion rate (AER) in NIDDM patients with increased urinary albumin excretion. RESEARCH DESIGN AND METHODS: Twelve NIDDM hypertensive patients (age 52 +/- 3 years, HbA1c 7.7 +/- 0.2%) on antihypertensive treatment were enrolled in a double-blind placebo-controlled study, assuming either placebo or sulodexide (100 mg/day) for 4 months; at the end of this period, a crossover was performed. We have evaluated routine biochemical parameters plus AER and coagulative function every 2 months. RESULTS: Both plasma fibrinogen (from 4.15 +/- 0.32 to 2.77 +/- 0.47 mmol/l) and AER (from 128.3 +/- 40.6 to 39.6 +/- 11.9 micrograms/min) decreased significantly after treatment with glycosaminoglycans in respect to placebo; moreover, blood pressure control ameliorated, also in the absence of any variation of therapy. CONCLUSIONS: Glycosaminoglycan therapy, likely in association with a satisfactory control of blood pressure values, seems to prevent the progression of diabetic nephropathy in NIDDM.

Administration, Oral↗
PubMed1997

Multicentre study on the prevalence of symptoms and symptomatic treatment in HIV infection. Central Italy PRESINT Group.

We investigated the prevalence and intensity of symptoms and the use of drugs for symptom control among all HIV-infected patients reporting to the outpatient clinics or wards of 15 clinical centres in central Italy, recording clinical and epidemiological data on three consecutive days. A total of 1128 patients were observed and tabulated. Their most frequent symptoms were asthenia (65%), anorexia (34%), cough (32%), pain (29%), and fever (29%). Opioid analgesics were used in 3% of these patients and non-opioid analgesics in 13%. A large majority of HIV-infected patients presented with symptoms regardless of the stage of their disease. Pain was present in fewer than one third of patients but nonetheless seemed to be undertreated. Pain was more frequent and more intense among intravenous drug users. Based on our study, a greater effort to control symptoms in HIV patients seems to be warranted.

Analgesics↗
PubMed1997

[Prognostic value of histologic classifications of advanced stomach cancer: comparative study of Lauren's and Goseki's classifications].

Controversy exists about the prognostic value of the histological classifications of gastric cancer commonly used. Recently Goseki proposed a new classifying system based on intracellular mucus production and the degree of tubular differentiation. The aim of this study was to compare Lauren and Goseki classifications with particular emphasis on their prognostic significance. Eighty-nine patients, who underwent potentially curative resections (RO) and radical lymphadenectomy for advanced gastric cancer from September 1988 to April 1996 were analysed. Cox regression model was used to evaluate the prognostic significance of Goseki classification, Lauren classification, age, sex, type of lymphadenectomy, depth of tumour invasion (T), node metastases (N) and number of metastatic nodes. A statistically significant correlation between the different Goseki grades and histology according to Lauren was found (p < 0.001). By multivariate analysis the only parameters predictive of long term outcome were depth of tumour invasion, nodal status and histology according to the Lauren classification. Also after excluding the Lauren classification from the analysis, the Goseki histological grading system did not affect survival independently. This study on advanced gastric cancer patients identified depth of invasion, lymph node metastases and Lauren classification as significant independent pathological variables influencing survival. The classification proposed by Goseki did not add anything further to the prognostic informations provided by TNM staging and Lauren classification.

Adenocarcinoma↗
PubMed1996

Scleral buckling surgery in stage 4 retinopathy of prematurity.

BACKGROUND: Technical advances in neonatal intensive care have significantly increased the number of very low birth-weight babies that survive the perinatal period. Some of these infants develop severe retinopathy of prematurity that may lead to retinal detachment. METHODS: Between November 1988 and January 1994, 28 eyes from 15 preterm babies underwent scleral buckling for stage 4 retinopathy of prematurity at a mean age of 4.2 months. Cryotherapy was performed preoperatively on 12 eyes and intraoperatively in the remaining 16 eyes. The mean follow-up period was 35 months. RESULTS: Scleral buckling produced retinal reattachment in 13 eyes (46.4%). Severe myopia (-5 D to -15 D) was found in all 13 of these eyes, 12 also presented convergent strabismus. Mean visual acuity, measured in 6 eyes from children over the age of 3 years was 20/40. In 7/28 eyes of the younger children of this group we found a fix and follow the light capability. No light perception was detected in 11/28 eyes; in the remaining 4/28 eyes there was only light perception. Scleral buckling failed to prevent the progression to stage 5 in 15 eyes (53.6%). Additional surgery was excluded for 9 of these eyes based on ultrasonography findings; the other 6 eyes underwent vitrectomy, which led to macular reattachment in 4 cases. CONCLUSIONS: Clinical experience shows that scleral buckling is not always capable of preventing progression of the disease to stage 5. Furthermore, even when the anatomic results of this procedure are good, the functional outcome is often complicated by severe visual impairment.

Birth Weight↗
PubMed1996

Bone heterograft for chest wall reconstruction after sternal resection.

BACKGROUND: Experimental and clinical results of chest-wall reconstruction with bone heterograft after sternectomy are reported. METHODS: Seven dogs underwent subtotal or total sternectomy and reconstruction by implantation of a cortico-spongy bone heterograft sandwiched between two layers of a reabsorbable mesh. RESULTS: No major postoperative complications were observed. The implant has shown favorable mechanical and biological properties. Six and 9 months after operation all animals were sacrificed and pathologic examination showed good incorporation of the implanted bone with only partial resorption of its spongiosa. Subsequently, 2 patients underwent sternal resection with different indications and reconstruction was achieved by the technique developed experimentally. No complications were observed. Excellent immediate chest-wall stabilization was obtained, persisting for a follow-up period longer than 6 months. CONCLUSIONS: In comparison with autologous bone, sterile bone heterograft seems to offer the same mechanical properties with a significantly reduced surgical trauma.

Adult↗
PubMed1996

Symptom profile in terminally ill AIDS patients.

A study protocol to record prospectively, frequency and intensity of symptoms in terminally ill AIDS patients was developed. Other information included mode of transmission, active intravenous drug use, regular visits of family/friends to the ward, the use of symptom-control drugs, and death without family or partner. The study population was selected from patients admitted to the wards or followed in the Clinic or Day Center of the Department of Infectious Diseases of the Catholic University, Rome. Inclusion criteria were diagnosis of AIDS prior to 12 months and advanced stage AIDS (defined with standardized criteria). To standardize the analysis of data, the terminal phase was considered to start 3 months before death (T1). From January 1, 1993 to December 12, 1993, 266 patients (208 males, 58 females) were enrolled. By June 30, 1995 168 patients had died and were considered for analysis. The most frequent symptoms at T1 were anorexia (63.1%), fatigue (60.1%), pain (60.1%), fever (47.6%), and cough (37.5%). At the end week (T6) the most frequent symptoms were fever (81.5%), fatigue (70.2%), dyspnea (68.1%), and pain (58.9%). In two-thirds of the patients, symptom-control drugs were used, most frequently nonopioid analgesics (39.9% at T1 and 56.5% at T6) and antipyretics (38.7% at T1 and 53.6% at T6). Opioid analgesics were used in 19% of patients at T1 and in 28.6% at T6. Almost one-third of the patients (29.2%) died alone without having family, their partner, or a friend near. Considering the high frequency of treatable symptoms in terminally ill AIDS patients, the use of palliative therapy should be emphasized. Flexibility and patient-directed care should be used in deciding care plans to avoid overhospitalization and promote alternative care.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Ultrasonography mapping of peritoneal adhesions].

A previous laparotomy is still a contraindication to laparoscopy because of the possible presence of abdominal wall adhesions exposing the patient to the risk of a visceral injury when the pneumoperitoneum is created and/or the first trochar is inserted. We report the results of abdominal wall US exams performed preoperatively for the diagnosis of peritoneal adhesions: we investigated two distinct signs unrelated to one another, to minimize false-negative findings. Ultrasonography was performed on 141 patients subdivided into two groups: 81 patients with no previous abdominal surgery (group A) and 60 patients with a history of abdominal surgery (group B). For diagnostic purposes, the visceral movement sign according to Sigel, modified on the basis of preliminary observations, and the reflection band sign were studied. US data were included in the patient's record and compared with intraoperative findings. Overall diagnostic accuracy was 94% and sensitivity 100% in the two groups. To conclude, the preoperative US mapping of abdominal wall adhesions enabled us to establish adhesion-free areas unquestionably and thus to choose the safest and most suitable sites for risky maneuvers during laparoscopy in the patients with a history of previous abdominal surgery.

False Positive Reactions↗
PubMed1995

Detection of platelet-associated antibodies by flow cytometry in hematological autoimmune disorders.

We describe our experience in the evaluation of platelet-associated immunoglobulins (PAIg) by flow cytometry in comparison to solid-phase assay in patients affected by idiopathic thrombocytopenic purpura and by Evans syndrome. Results show that the analysis of PAIg by flow cytometry is easy and reliable and correlates well with data obtained by the solid-phase technique. In addition, flow cytometry allows the evaluation of samples containing small numbers of platelets (< 20,000/mm3); the analysis is objective, not influenced by personal experience. Moreover, flow cytometry appears simple enough to be performed in a routine laboratory, and data might be retrieved to perform batch analysis. Our results appear to indicate that PAIg flow cytometry might be a sensitive tool for the evaluation of patients with autoimmune thrombocytopenia.

Autoantibodies↗