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Biomedical subjects

F Ricci

Publications and source records attributed to F Ricci.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

The epidemiology of severe malaria in an area of low transmission in Thailand.

The predisposing factors, clinical presentation, and outcome of severe malaria in a Karen community living on the western border of Thailand were studied over a period of 2 years. This was an area of low malaria transmission (approximately one infection per person per year), where asymptomatic malaria is unusual. In a population of 4728 persons, who had good access to facilities for malaria diagnosis and treatment, there were 2573 cases of vivax malaria, none of whom died, and there were 5776 cases of falciparum malaria, 303 (5%) of whom had severe malaria and 11 (0.2%) of whom died-a case fatality rate of 1.9 per 1000 (95% confidence interval [CI] 1.0-3.3). The risks of developing severe malaria and dying declined steadily with age. The clinical features of severe malaria differed between children and adults. Anaemia was more common in children under 5 years old than in older children and adults, whereas the incidence of cerebral involvement increased with age. Severe malaria was 3 times (95% CI 1.4-6.2) more common in pregnant than in non-pregnant women, but was 4.2 times (95% CI 2.3-7.9) less common in patients with mixed Plasmodium falciparum and P. vivax infections than in those with P. falciparum alone, suggesting that P. vivax may attenuate the severity of P. falciparum malaria.

Adolescent↗
PubMedDate not supplied

Strategies for teaching safety education to children with special needs.

A nurse describes how a student community health project was used to develop a unique safety education program. Seat belt safety was presented to a group of school-age children who had special physical and emotional needs. The author lists the overall principles of conducting an educational session and provides examples of how those principles were applied with this student group.

Child↗
PubMedDate not supplied

Ultrastructural phenotype of "intestinal-type" cells in columnar-lined esophagus.

An intestinal-type epithelium is often present at columnar-lined esophagus, gastroesophageal junction or within the so-called short segment Barrett's esophagus, but ultrastructural study failed to detect enterocytes in columnar-lined esophagus. The authors have analyzed the intestinal aspects present in areas of columnar-lined esophagus in a population of patients with reflux esophagitis to better understand the morphology and histogenesis of the proliferating elements. Columnar-lined mucosa was studied in 35 patients. Columnarsurface cells displayed a wide spectrum of ultrastructural features. Well-differentiated columnar secretory cells, secretory-absorptive cells, poorly differentiated columnar cells, atypical columnar cells, and goblet cells were detected. Well-differentiated absorptive cells were never found, These results demonstrate that the areas of intestinal metaplasia show a wide spectrum of ultrastructural phenotypes, ranging from poorly to well-differentiated cells. However, true enterocytes were not found and the most represented phenotype is that of secretory-absorptive cells, whose principal characteristic is the presence of secretory and absorptive aspects together. They can be described as secretory enterocytes or cells with double specialization. To the authors' knowledge, similar cells were not previously described in normal intestinal mucosa, and ultrastructural studies are consistent in describing a broad spectrum of ultrastructural features, suggesting that Barrett's specialized metaplasia is derived from cells with the capacity for a wide range of differentiation. Therefore, despite the wide use of term intestinal metaplasia in the medical literature, experimental data clearly failed to detect enterocytes in the columnar-lined esophagus, and ultrastructural data do not support the concept of intestinal metaplasia. The cellular heterogeneity seems to be the result of a "phenotypic shift" of undifferentiated elements, which show a different pattern of evolution. The result of this process is the formation of new cell types dissimilar from those normally present in esophageal, gastric, or duodenal mucosa.

Adolescent↗
PubMedDate not supplied

Immuno-chemotherapy of advanced colorectal cancer with alpha-2a interferon and 5-fluorouracil. Immunopharmacological studies.

Twelve patients with metastatic colorectal cancer received alternating cycles of low immunomodulating doses of alpha-IFN + 5-Fluorouracil (5-FU) or 5-FU alone. Hematological, biochemical and physical evaluation showed that both treatment cycles were well tolerated. However, transient fever and moderate flu-like symptoms were observed following alpha-IFN administration. Treatment with 5-FU alone produced long-lasting inhibition of CD8+ T lymphocytes, but did not depress NK activity (NKA). Combined treatment with alpha-IFN produced a short-term increase of NKA and antagonized the effect of 5-FU on CD8+ cells on day 5 of the cycle. Parallel studies on in vitro models showed antiproliferative effects of 5-FU on PHA-stimulated MNC and confirmed the preferential inhibition of CD8+ cells. Pretreatment with alpha-IFN did not reverse the effect of 5-FU on CD8+ lymphocytes, but partially protected MNC from the toxic effects of the drug. This was presumably due to the cytostatic effects induced by alpha-IFN on MNC before exposure to the cycle-specific antineoplastic agent. This investigation suggests that alpha-IFN could play a positive role in immuno-chemotherapy of colorectal cancer through multiple mechanisms not entirely related to direct antitumor effects of the agent.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Efficacy and toxicity of vinorelbine-carboplatin combination in the treatment of advanced adenocarcinoma or large-cell carcinoma of the lung.

AIMS AND BACKGROUND: The aim of the study was to assess the activity and toxicity of the vinorelbine-carboplatin combination in advanced adenocarcinoma or large-cell carcinoma of the lung. The new vinca derivative, vinorelbine, shows promising activity when combined with cisplatin, but toxicity of the combination is substantial. METHODS: Accordingly, we substituted carboplatin for cisplatin in the combination in order to improve the therapeutic index. From March 1992 to March 1994, 55 untreated patients with undifferentiated unresectable or metastatic adenocarcinoma or large-cell carcinoma of the lung were recruited. The treatment consisted of a course of carboplatin (300 mg/m2) and vinorelbine (25 mg/m2) repeated every 4 weeks. The only grade 3 toxicity observed was 16 cases of grade 3 vomiting and 2 cases of grade 3 stomatitis. RESULTS: The positive response rate was 40% (partial response, 22 patients). In conclusion, the vinorelbine-carboplatin combination may be regarded as an active, safe regimen for the palliative treatment of advanced adenocarcinoma or large-cell carcinoma of the lung.

Adenocarcinoma↗
PubMedDate not supplied

Indocyanine green dye-enhanced micropulsed diode laser: a novel approach to subthreshold RPE treatment in a case of central serous chorioretinopathy.

PURPOSE: To present a case of central serous chorioretinopathy (CSC) treated with indocyanine green (ICG) dye-enhanced subthreshold micropulsed diode laser photocoagulation. METHODS CASE REPORT: A 35-year-old man presenting with recurrent CSC with persistent serous detachment of the sensory retina in his left eye who declined treatment with a 532 nm laser. Subthreshold treatment, with no visible endpoint, was performed with an 810 nm diode laser 15 minutes after the injection of 25 mg ICG in 2 cc of 5% glucose solution. The laser energy was delivered over the active leakage sites with a sequence of repeated 500 ms "envelopes" each containing a train of 250 micropulses with 500 mW peak power at 10% duty cycle (200 micros ON and 1,800 micros OFF) and each separated by 500 ms intra-envelopes relaxation time. Due to the absence of visible laser-induced lesions, post treatment ICG digital angiographic images were taken without further dye injection to verify that the hypofluorescent spots resulting from the subthreshold laser applications coincided with the points of leakage. RESULTS: After 7 days, the patient presented with a less hyperopic refraction, improved visual acuity, and reduction of serous neuroepithelial detachment. No signs of laser treatment were visible at fluorescein angiography. After 8 weeks, the serous neuroepithelial detachment was almost completely resolved. CONCLUSIONS: ICG dye-enhanced subthreshold micropulsed diode laser photocoagulation appears to be a safe and effective treatment and represents a possible approach for the management of chronic CSC with persistent central serous neuroepithelial detachment. Immediate post treatment ICG angiography, without ICG reinjection, allows documenting the actual number and location of the delivered subthreshold laser applications.

Adult↗
PubMedDate not supplied

Argon laser trabeculoplasty in triamcinolone acetonide induced ocular hypertension refractory to maximal medical treatment.

PURPOSE: To report two cases of intraocular hypertension after intravitreal injection of triamcinolone acetonide (iTAA) that were refractory to maximal medical therapy and were successfully treated with argon laser trabeculoplasty (ALT). METHODS: Two patients with history of primary open angle glaucoma were treated with intravitreal injection of triamcinolone acetonide for chronic macular edema secondary to branch retinal vein occlusion. Both patients (Case 1 after 2 months and Case 2 after 5 days) developed intraocular hypertension that did not respond to maximal medical therapy. Despite medical therapy, intraocular pressure (IOP) was 45 mmHg in Case 1 and between 34 and 37 mmHg in Case 2. ALT was performed in the inferior 180 degrees angle using the following parameters: 50 microm size, 700 mW, 0.50 sec, 100 spots. RESULTS: In both patients IOP returned to normal level a few days after ALT. CONCLUSIONS: ALT seems to be effective at reducing IOP in patients with intraocular hypertension secondary to iTAA that does not respond to maximal medical treatment.

Aged↗
PubMedDate not supplied

Incidence of sepsis in central venous catheter-bearing patients with hematologic malignancies: preliminary results.

BACKGROUND: Indwelling central venous catheters (CVCs) are essential devices in the management of patients with hematological disorders treated with chemotherapy. However, their nature predisposes patients to unwanted complications. METHODS: CVC-related complications were retrospectively analyzed in 227 hematologic patients who were consecutively admitted to our hematology department between May 2002 and April 2004. Patients' diagnoses comprised acute myeloid leukemia (36.8%), acute lymphoid leukemia (7.3%), lymphoproliferative disorders (28.3%), multiple myeloma (19.5%), myeloproliferative syndromes (5%) and others (3.1%). The CVCs used were polyurethane three lumen 7-Fr (111 patients) for chemotherapy and 12-Fr (114 patients) for chemotherapy and peripheral blood stem cell apheresis, plus two tunneled catheters. RESULTS: The pathological events were: bacteriaemias (n=46); occlusions (n=10); exit tunnel infections (n=8); thrombosis (n=6); lung emboli (n=2). Among febrile patients the bacteriemia frequency was 20%, of which 13.6% were CVC-related (with a higher incidence in leukemia patients (p=0.027). Among the isolates, gram-positive bacteria were found in 29 cases (23 CVC-related cases), and gram-negative bacteria in 16 cases (8 CVC-related cases). Only one patient had Candida albicans sepsis. At univariate and multivariate analysis significant risk factors for infection (p<0.0001) were only the number of days/catheters and neutropenia duration. CONCLUSIONS: In our hematologic patients, the CVC complications were mainly septic, with only 10.1% of CVC-related bacteriemias, despite prolonged catheterization duration. Acute leukemia patients were at major risk for sepsis, probably due to a more severe neutropenia and prolonged catheterization duration.

Journal Article↗
PubMedDate not supplied

Plasma and tissue prolactin detection in colon carcinoma.

Serum concentrations of prolactin, a trophic hormone produced by the pituitary gland, have been shown to be raised in certain group of patients with cancer. Prolactin was detected in 0-20% of the colon cancer by immunohistochemistry and in plasma in 6-53% of the patients. These conflicting results do not support the hypothesis of an ectopic prolactin production by colon carcinoma. The aim of this study was to confirm the reported incidence of hyper-prolactinemia in colorectal cancer and to find further evidence for an ectopic prolactin production by the tumor. Thirty consecutive patients with colon carcinoma were studied. Before surgery all the patients underwent blood sample collection to assay plasma prolactin levels. All patients underwent colectomy. All the neoplastic specimens were tested with antiprolactin antibody. In none of the patients were significantly high preoperative levels of plasma prolactin found. Prolactin immunostaining was not identified in any of the tumor specimens. We could not confirm previous reports of frequent hyperprolactinemia in patients with cancer. This is the first report in which the incidence of both hyperprolactinemia and prolactin positive immunostaining was 0%. Our study was unable to demonstrate the synthesis of prolactin by colorectal cancers. The tumor is unlikely to be the source of hormone production. Our results suggest that circulating prolactin levels cannot be used as prognostic marker in patients with colon cancer.

Aged↗
PubMedDate not supplied

Management of caudate lobe injury. Case report.

This article describes a case of abdominal trauma with laceration of the caudate lobe, avulsion of its short hepatic veins and tear of the inferior vena cava (IVC). Anatomic segmentectomy of I segment and direct suture of inferior cava vein was performed. On its arrival to the Emergency Department the patient was hemodynamically stable. Ultrasonography and CT scan demonstrated a fracture of I hepatic segment associated to a retroperitoneal haematoma. Because progressive anemia and unstable hemodynamic state, the patient was taken to the operating room for intervention. No postoperative complications due to surgery were reported. The patient left the hospital in XXII postoperative day, after normalization of clinical parameters.

Humans↗
PubMedDate not supplied

Traumatic diaphragmatic injuries.

Traumatic diaphragmatic rupture is an uncommon but important problem in patients with multiple injuries. A retrospective analysis of 37 cases with diaphragmatic injuries, 34 of the left and 3 of the right hemidiaphragm, was carried out. Thirty-two patients were treated surgically during the acute phase and 5 after a variable delay post-trauma. Diagnostic problems are discussed, so also for comportance of a proper evaluation of chest films. Factors leading to a strong suspicion of diaphragmatic rupture in patients suffering from thoraco-addominal blunt trauma are emphasized in order to recognize diaphragmatic lesions. Finally, surgical treatment is considered. In most cases, laparotomy is the access route of choice, not only to achieve reduction of herniated viscera and repair of the diaphragmatic lesions, but also to treating the frequently associated intra-abdominal injuries. Whenever thoracotomy is required, it should always be performed via a separate incision.

Adolescent↗
PubMedDate not supplied

Heterotaxia: radiological and surgical observations in a case of polysplenic syndrome.

We describe a case of asymptomatic polysplenic syndrome as suggested by ultrasonography, gastrointestinal series, computed tomography, magnetic resonance imaging scans and arteriography, and confirmed at surgery. Spleen malformation is frequently associated with heterotaxia and other malformations of the thoracic and abdominal organs, but no pathognomonic features can be detected in relation to this condition. In our patient, imaging studies revealed the presence of a polylobulated spleen in an atypical position below the liver, associated with malpositioning of the gastric fundus and gastro-oesophageal junction with interruption of the inferior vena cava, but no congenital heart disease. In conclusion, polysplenic syndrome is a rare clinical condition, occasionally found in asymptomatic adults. Radiological detection could be mistaken for mediastinal or abdominal pathological masses, and only a thorough study performed with several different radiological methods can determine the precise anatomy of the structures involved so as to be able to plan surgery where necessary.

Female↗
PubMedDate not supplied

[Use of the Dynamic Stent in the palliation of carinal and distal tracheal stenosis].

Satisfactory palliation of the lesions involving the carinal region is difficult to achieve because the stenting is conducted in an unsuitable anatomy, in highly symptomatic patients. During the period 1987-2000 we performed 785 operative rigid bronchoscopies in 524 patients, 184 of whom received a respiratory stent. The stenting of the carinal region was carried out in 27 patients with the use of the Frietag Dynamic stent. In this group of patients indication for stenting was as follows:--advanced lung cancer (22);--esophageal cancer invading the lower trachea (1);--severe tracheobronchomalacia (2);--postintubation stenosis of the lower trachea (2). No perioperative mortality was observed. All patients experienced symptomatic improvement. Follow-up ranged from 1 to 60 months: all neoplastic patients died for advanced disease without significant respiratory problems with a median survival of 5.6 months; three patients treated for benign diseases are still alive at 2, 31 and 65 months from stent deployment. No major complications were observed: in two patients the stent was removed after few days due to mucous retention; furthermore we observed symptomatic respiratory infections caused by a residual space between the tracheal wall and the prosthesis in other two patients with severe COPD. Dynamic stent is to be considered the stent of choice for palliation of the carinal region because it is effective and well tolerated with a low complications rate. The main limitations of such prosthesis are the shortness of the right bronchial branch and the size, sometimes inadequate.

Adult↗
PubMedDate not supplied

Solitary splenic recurrence of epithelial ovarian cancer: a case report and review.

The metastatic involvement of the spleen in epithelial ovarian cancer is rare and usually reflects late disseminated disease. Isolated parenchymal metastasis in the spleen is an extremely unusual event, in fact in most cases in medical literature, the spleen was involved as part of diffuse peritoneal carcinomatosis. We report a rare case of epithelial ovarian carcinoma, which recurred in the splenic parenchyma 15 years after initial treatment. The patient underwent a splenectomy followed by six cycles of platinum-based poly-chemotherapy. Currently, 8 years after splenectomy, the patient has no evidence of relapsed disease. In the solitary splenic recurrence of epithelial ovarian cancer our case suggests that accurate surgical resection of the spleen, followed by platinum-based chemotherapy, is correlated with a prolonged survival.

Adenocarcinoma↗
PubMedDate not supplied

[Metahemorrhagic adrenal pseudocysts: our experience].

Hemorrhagic adrenal cysts are a pathologic entity rarely described in literature. In this paper we present two cases of hemorrhagic adrenal cyst and we discuss about diagnosis and therapy.

Adrenal Gland Diseases↗
PubMedDate not supplied

[Leiomyoma of the nipple (a case report and review of the literature)].

The leiomyoma of the nipple is a very rare affection. No more than 20 cases are reported in the literature of the last 50 years. This neoplasm presents a difficult differential diagnosis with the remaining phlogistic and neoplastic breast diseases. We report a personal case with a review of the literature.

Breast Neoplasms↗
PubMedDate not supplied

[A comparison between manual and mechanical anastomoses in digestive organ surgery].

The authors review the literature from 1980 to 1990 about some kinds of digestive anastomosis: esophagogastric and esophagocolic anastomosis at neck, esophagogastric intrathoracic anastomosis, esophagojejunal anastomosis, colorectal anastomosis. They compare the results of manual versus mechanical procedure in the light of recent personal clinical experience.

Anastomosis, Surgical↗