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Biomedical subjects

F Salvestrini

Publications and source records attributed to F Salvestrini.

At least 19 recordsLinked to original sources
PubMed2002

Weekly epirubicin in patients with hormone-resistant prostate cancer.

The aim of this study was to investigate the benefit of weekly epirubicin in the treatment of metastatic hormone-resistant prostate cancer. One hundred and forty-eight patients with metastatic hormone-resistant prostate cancer received weekly 30-min intravenous infusions of epirubicin 30 mg m(2) of body surface area. The primary end-point was palliative response, defined as a reduction in pain intensity and an improvement in performance status. The secondary end-points were the duration of the palliative response, quality of life and survival. Fifty-seven (44%) of the 131 evaluable patients met the primary criterion of palliative response after six treatment cycles and 73 (56%) after 12 cycles; the median duration of the response was 9 months (range 1-11). The median global quality of life improved in 52% of the patients after six cycles and in 68% after 12 cycles. The 12- and 18-month survival rates were respectively 56 and 31%, with a median survival of 13+ months (range 1-36). The treatment was well tolerated: grade 3 neutropenia was observed in 8% of the patients, grade 3 anaemia in 7%, and grade 3 thrombocytopenia in 3%. None of the patients developed grade 4 toxicity or congestive heart failure. Weekly epirubicin chemotherapy can lead to a rapid and lasting palliative result in patients with metastatic HRPC, and have a positive effect on the quality of life and survival.

Aged↗
PubMed2001

Urinary calcium excretion in the monitoring of bone metastases from prostatic carcinoma.

BACKGROUND: One of the greatest problems in treating advanced prostate carcinoma is monitoring the therapeutic response of bone metastases. As these metastases are mainly osteosclerotic and lead to a markedly increased bone calcium requirement that may give rise to an imbalance in calcium homeostasis, the authors investigated whether changes in calcium balance may be useful for evaluating the response of bone metastases to treatment. METHODS: The study involved 268 prostate carcinoma patients: 142 in Stage A-C2 (International Union Against Cancer [UICC] staging system, 1998) and 126 with bone metastases who had failed to respond to hormone therapy and were receiving chemotherapy. Prostate-specific antigen (PSA), calcium and phosphate metabolism, and the main bone formation and resorption markers were all assayed before and after chemotherapy. RESULTS: Of the 126 patients on chemotherapy, 109 were evaluable for response: according to standard criteria, 25 (23%) had improved, 43 (39.5%) were unchanged, and 41 (37.5%) had worsened. All of the improved and 16 unchanged patients had decreased PSA and bone marker levels and an increased urinary calcium/creatinine ratio (UCa/Cr); the worsened patients had increased PSA and bone marker levels, and their UCa/Cr decreased after only six treatment cycles. PSA and UCa/Cr were the biochemical markers whose changes showed the best agreement with treatment response. CONCLUSION: The UCa/Cr ratio was the most useful marker of clinical response, mainly because it allowed an early decision to continue or to stop chemotherapy. Furthermore, UCa/Cr and PSA together identified a percentage of patients classified as unchanged on the basis of standard criteria but whose condition had actually improved.

Bone Neoplasms↗
PubMed2000

[Is total parenteral nutrition necessary in patients subjected to radical cystectomy?] .

BACKGROUND: The aim of the study is to evaluate the nutritional stats in candidates to radical cystectomy in order to minimize post-operative complications. METHODS: The evaluation is carried out on the basis of anthropometric, bio-humoral and immunologic indexes in a retrospective analysis of patients who underwent major urologic surgery during the last two years. Twenty cases of invasive bladder cancer (mean age 71 years) who underwent radical cystectomy have been studied: in 13 cases urinary diversion by Camey II technique, in 7 cases by Bricker technique has been performed. In 5 cases of orthotopic neo-bladder, endovenous parenteral protein sparing nutrition was carried out for 4 days, in the remaining 15 cases glucidic and saline solutions have been administered. RESULTS: In all the 20 evaluated patients post-operative complications have not been observed. CONCLUSIONS: On the basis of the data obtained, the conclusion is drawn that patients with bladder cancer are generally not so malnourished to need an artificial feeding regimen. Considering the urinary tract substitution effects on renal function and metabolism, particularly for the role of glucose on proximal and distal tubule the usefulness of administering only glucidic solutions and maintaining a good diuresis is underlined.

Aged↗
PubMed1998

[Short bowel syndrome].

In the last year at the Department of Surgery of the University of Siena two patients presenting a clinical feature of intestinal infarct have been operated. In these patients a wide intestinal resection has been performed. After this surgical operation, a patient had a residual tract of 40 cm of bowel and the other 50 cm. It was not possible during operation to preserve the Bauin valve in a case; in the other, this valve has been sacrificed during a previous operation for cecal neoplasm. In the postoperative period, patients were transferred temporarily in the intensive care unit, and after some days they returned to the department where total parenteral nutrition with progressive decreasing mixture in calories over time was administered. Enteral nutrition was also started and the quantity of water, calories and azote was slavly increased. In a second time an oral diet was started up to completely weaning from parenteral and then enteral nutrition. At present, these patients are enlisted in quarterly follow-up and are completely stabilized. They are independent from artificial nutrition and they have a good quality of life.

Aged↗
PubMed1998

[Total gastrectomy and malnutrition].

BACKGROUND: The operation more frequently performed for gastric malignancy is total gastrectomy. METHODS: Our reconstructive technique is Roux en Y esophago-jejunostomy, jejunal interposition after gastrectomy. In the next weeks after operation there is always an important, sometimes pathologic, slimming in gastrectomized patients. But is this slimming due to malnutrition or malabsorption? This is the real question. In our Institute a quarterly perspective clinical and instrumental follow-up for these patients has been prepared. RESULTS: We started with 41 patients, but we conducted the complete study only on 23. Of these patients, 56% have lost 10 kg weight, 25% 5 kg and 18% have not lost weight after 2 weeks from discharge dimission. But after 5 weeks, all patients had stabilized their own weight, and 18 months later the first two groups regained weight again, 1-2 kg. With our follow-up, we had educated patients to a correct personal natural diet necessary to normal social and working life. With our program in 3-4 weeks the weight of each patient was stable and we were able to control the malabsorption. CONCLUSIONS: Moreover, according to personal experience, it is important to plan a follow-up to rehabilitate patients to usual social life. This program allows to evaluate malnutrition and the possible iron or vit. B12 deficiency.

Aged↗
PubMed1997

[Further comment on central venous catheter infections].

Many reports from the surgical literature document the incidence of catheter related sepsis varies between 1 and 10 per cent. In many instances sepsis is secondary to contamination from normal saprophyte cutaneous bacteria. In our Institute we set down a standardized methodology to reduce the contamination of venous central access from cutaneous bacteria. Of 31 patients studied, none had bacteria in the last 5 cm of central venous catheter, 2 had streptococcus alpha haemolytic colonies and coagulase negative staphylococcus colonies at the same time on skin over the region of venepuncture. With our paper we had attained one's awareness that it is very difficult to obtain zero per cent in contamination of central venous catheter, mainly in immunodepressed or critical patients, but with careful dressing and with new technology it is possible to reduce the contamination and following sepsis.

Aged↗
PubMed1996

Comparison between a cisplatin-containing regimen and a carboplatin-containing regimen for recurrent or metastatic bladder cancer patients. A randomized phase II study.

BACKGROUND: The aim of this randomized Phase II study was to compare the efficacy and toxicity of a cisplatin-containing regimen with a carboplatin-containing regimen for patients with recurrent or metastatic bladder cancer. METHODS: Fifty-seven patients with recurrent or metastatic bladder cancer were randomized to receive M-VEC treatment (methotrexate, vinblastine, epirubicin, and cisplatin) (n = 29) or M-VECa treatment (methotrexate, vinblastine, epirubicin, and carboplatin) (n = 28). The chemotherapy was scheduled at 28-day intervals. Recombinant granulocyte-colony stimulating factors were administered daily when the absolute neutrophil count fell below 1000/mm3. The development of ototoxicity was evaluated by measuring auditory brain stem response. RESULTS: Of the 57 entered patients, 55 were evaluable for response and toxicity. The overall clinical response rate was 71% (with 25% complete responses) in the M-VEC group and 41% (with 11% complete responses) in the M-VECa group (P = 0.04). M-VEC chemotherapy was associated with more pronounced side effects. There was a statistically significant difference between M-VEC and M-VECa in terms of gastrointestinal toxicity (P = 0.04), nephrotoxicity (P = 0.03), and neurotoxicity (P = 0.02) during Cycle 3 of chemotherapy. Leukopenia and neutropenia were worse in the M-VECa arm, but not significantly so (P = 0.4). Ototoxicity was only detected in one of seven examined M-VEC patients after two cycles of chemotherapy. CONCLUSIONS: M-VECa has a low level of gastrointestinal, renal, neurologic, and otologic toxicity, but is apparently less effective than M-VEC in the treatment of recurrent or metastatic bladder cancer. However, a larger, randomized Phase III trial is needed to confirm these results.

Aged↗
PubMed1984

[The use of prostheses in recurrent hernias].

The use of inert plastic (Prolene mesh, 0,027 inches in thickness fournited by Ethicon) as preperitoneal prosthesis in repair of incisional hernias and inguinal hernia recurrencies has been investigated in 28 patients operated upon then 1977 to 1984. In 9 patients the inguinal approach was used with one recurrence (11%). In 9 patients the posterior approach through a midline incision has been used with two recurrences (22%). In 10 patients with incisional hernias there was only one recurrence (10%). Total recurrences rate was 14%. Most recurrences occur in patients operated from 1977 to 1980 (40%). Patients operated in the last period from 1980 to 1984 had no recurrences.

Adult↗
PubMed1984

[Anal sphincter function following colorectal anastomosis with a stapler by transperineal-sphincter approach].

In 4 patients who under went low anterior resection for cancer of mid and lower 1/3 of the rectum, with colo-rectal anastomosis by posterior transphinteric approach, anorectal pressure profiles have been studied by open tip technique 30 d. 6 months following operation. Bowel movements, gas and feces discrimination and anal continence were also controlled. Resting pressure, delta % pressure changes during recto-anal reflex, pressure in voluntary contraction, altered in the first post-operative period, become normal in 6 months. Although volume and pressure at urgent rectal sensation, volume and rectal sensation and compliance altered after surgery did not change after 6 months, suggesting that the reservoir function of the rectum is lost, patients achieved a good control of bowel movements, and a good gas and feces discrimination and anal continence within the first 6 months of operation.

Anal Canal↗
PubMed1984

[The use of mechanical suturing in colorectal anastomoses].

In 16 patients affected by cancer of the mild or lower 3 of the rectum, has been performed a colorectal anastomosis by EEA Stapler, with abdomino-transanal approach. In the postoperative period no case of anastomotic bleeding or stenosis has been observed. 3 patients (18%) presented minor anastomotic dehiscence detected by radiologic examination, without clinical symptomatology. The EEA Stapler anastomosis seem sure almost as the traditional hand sutures, and allow the execution of anterior resection instead of abdominal perineal amputation of rectum.

Adult↗
PubMed1984

[The use of mechanical suturing in esophago-jejunal anastomoses].

10 esophagojejunostomies by EEA Stapler were performed on adult patients (8 males and 2 females, mean age 54 years), after total gastrectomy for gastric cancer. No postoperative bleeding or stricture were observed. 2 anastomotic leaks occurred (20%). The major cause of anastomotic failure is probably technical (incorrect assembly or lubrication of the instrument). According to the our experience and to literary data, the use of stapling devices for performance of esophagojejunostomies is recommended.

Adult↗
PubMed1984

[Strain-gauge plethysmography in the evaluation of the evolution of deep vein thrombosis of the legs].

Previous research has shown that MVO (Maximum Venous Outflow), VR (Venous Reflux), VE (Venous Emptying) and the respiratory waves recording are useful in differentiating occlusion and recanalization in postphlebitic syndrome. In the present work strain-gauge plethysmography was employed to quantitate the venous function after deep venous thrombosis of the legs. The studies were performed in a vascular laboratory with controlled temperature (23 to 25 C); records were obtained by a plethysmograph Parks mod. 270 connected to a Hewlett-Packard multi-channel mod. 7700. 17 patients (12 males, 5 females), mean age 55 years (range 24-75) that presented femoropopliteal thrombophlebitis documented by phlebography at the admission to the hospital were examined. MVO with and without superficial veins occlusion was measured by a mercury in silastic strain-gauge placed circumferentially about the calf. A pneumatic cuff thigh was inflated to 60 mm Hg. VE was measured in patients lying in inclined bed with the lower extremities 100 cm below the heart level compressing the calf with a pneumatic cuff 10 times for 5 seconds; the strain-gauge was placed on the foot level. VR after Valsalva's maneuver and the respiratory waves were recorded by a strain-gauge positioned at the maximum girth about the calf in patients lying on inclinated bed with the lower extremities 50 cm below the heart level. The result are here indicated: (Table: see text) There was differences in the evolution of venous function after deep venous thrombosis of the legs for each patient. Strain-gauge plethysmography may become evaluable non invasive technique in the evaluation of deep venous thrombosis evolution in the legs. The therapeutic assessment of postphlebitic syndrome.

Adult↗