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Biomedical subjects

G Botti

Publications and source records attributed to G Botti.

At least 19 recordsLinked to original sources
PubMed1992

[Survival after gastrectomy for cancer. 209 cases].

The long-term results of 209 gastrectomies performed for adenocarcinoma, including 117 which were prospectively collected, are presented. Resection was curative in 154 cases (73.6 percent). The TNM distribution of the tumours was: stage I (TxNOMO) 75 cases, stage II (TxN1MO) 46 cases, stage III (TxN2MO) 33 cases and stage IV (TxNxM1) 55 cases. Lymph node involvement was more frequent in the prospective than in the retrospective study. With a more than 5 years' follow-up of 80 percent of the patients operated upon, the actuarial survival rate at 5 years (operative mortality included) was 38 percent for all lesions, 52 percent for curative resection and 2 percent for palliative resection. Following curative resection, the survival rates for tumours of the upper, middle and lower thirds of the stomach were 40, 60 and 55 percent respectively. These rates were 60 percent for stage I tumours, 54 percent for stage II tumours and 25 percent for stage III tumours. The results obtained in this series, where most of the curative gastrectomies included excision of N1 and N2 lymph nodes, show that lymph node involvement has no significant importance for the prognosis when it is proximal (N1) and is not incompatible with prolonged survival when it is pedicular (N2).

Actuarial Analysis↗
PubMed1992

Clinical significance of coronary artery disease in hypertrophic cardiomyopathy.

The role of coronary artery disease (CAD) in hypertrophic cardiomyopathy (HC) has not been thoroughly clarified. To assess the clinical and prognostic significance of these 2 coexistent diseases, 96 patients with HC (62 men, mean age 45 years) who underwent coronary arteriography and 2-dimensional echocardiography were studied. Significant stenosis (greater than 70%) of 1 or more coronary arteries was detected in 11 patients, all aged greater than 45 years. This group, compared with the other group without significant CAD (n = 85), was characterized by an older age (59 +/- 7 vs 42 +/- 15 years; p less than 0.05), a greater prevalence of previous myocardial infarction (24 vs 0%; p less than 0.001), complex ventricular arrhythmias (100 vs 50%; p less than 0.05), non-obstructive forms (82 vs 46%; p less than 0.05), dilated (45 vs 7%; p less than 0.02) and hypocontractile left ventricle (36 vs 6%; p less than 0.01) and higher mortality (36 vs 8%; p less than 0.05) during a mean follow-up of 3.6 years. It is concluded that CAD associated with HC is a complex clinical syndrome, difficult to diagnose clinically, that can reliably be recognized by coronary angiography. CAD seems to play an important role in modifying the pathophysiology, the natural history and the prognosis of HC.

Adolescent↗
PubMed1992

Efficacy and tolerability of gallopamil in coronary heart disease: a double blind cross-over comparison with nifedipine.

Anti-ischaemic properties and tolerability of the calcium antagonist gallopamil were compared with those of nifedipine in a double-blind cross-over study performed in 20 patients affected by effort or mixed angina. The patients were of both sexes and aged 43-66 years; coronary angiography performed on 18 of them revealed at least one-vessel disease (stenosis greater than 70%). After a one week wash-out period the patients received placebo for 2 weeks; thereafter 10 patients were treated orally with gallopamil 150 mg daily and 10 patients with nifedipine 60 mg daily for 4 weeks. Before crossing-over to the alternate therapy a 2-week placebo period was allowed. The patients underwent cycloergometric exercise tests after each phase of treatment; workload was increased by 25 W every 3 min and the test was stopped in the presence of a typical angina or ST segment depression or age-predicted maximal heart rate. The results show that both exercise time and maximal workload were significantly increased by gallopamil and by nifedipine in comparison with placebo; also the maximal ST segment depression was significantly reduced by the two drugs. The number of patients developing angina and/or segment depression during exercise test was significantly reduced by both drugs compared to placebo. Time to onset of angina and time to ST depression greater than or equal to 1 mm were increased, though not significantly, by both calcium antagonists. No side effects were recorded with gallopamil while with nifedipine six patients reported side effects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Malignant melanoma of the nipple: a case studied with radiolabeled monoclonal antibody.

We describe a case of histologically confirmed malignant melanoma of the nipple. The rare occurrence of these lesions accounts for the relative lack of criteria for standard surgical treatment. After a conventional workup including mammography, chest X ray, bone scan, liver ultrasonography and cytologic smear of the lesion, we used specific radiolabeled monoclonal antibody and external photoscanning to differentiate melanoma from Paget's disease. The patient underwent wide local excision of the lesion and axillary node dissection, and tumor control is optimal since she has no evidence of disease after 5 years of follow-up.

Antibodies, Monoclonal↗
PubMed1990

Ten homozygous-D-individuals in one Italian village.

A large inbred Italian kindred with 10 members homozygous for the rare Rh gene complex-D-is described. The propositus has immune antibody to a high-incidence Rh antigen: her baby required exchange transfusion. None of the other 9-D-/-D- individuals has made antibody even though 2 were women with children. This kindred supports previous observations of the excess of consanguinity among the parents of -D-homozygotes. 40.9% (instead of the 25% expected) of the offspring of -D-heterozygous parents are -D-homozygotes.

Consanguinity↗
PubMed1990

Primary carcinoma of the vagina. Case report.

An unusual case of Primary Carcinoma of the vagina was recently observed. The patient was treated surgically in 1981 for squamous cervical carcinoma in situ (CIN 3); eight years later the same patient was treated for squamous carcinoma of the vagina that involved the upper, median and lower tract. She was treated with radical colpectomy and VBP chemotherapy for three courses. The pathology, natural history and treatment are discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[The clinical significance of signal-averaged electrocardiography in hypertrophic cardiomyopathy].

We examined 44 patients (pts) with hypertrophic cardiomyopathy to evaluate the prognostic value of signal-averaged electrocardiography and its possible correlations with clinical and instrumental data. All pts (31 male, 13 female, mean age 47 +/- 15) underwent clinical examination, standard electrocardiography, M-mode and two-dimensional echocardiography, 24-72 hour dynamic electrocardiography and signal-averaged electrocardiography. The mean follow-up was 14 +/- 4 months. Signal-averaged electrocardiography was performed using a 40-250 Hz bidirectional filter. An abnormal signal-averaged electrocardiography with late potentials (filtered QRS duration greater than or equal to 120 msec and root mean square voltage in terminal 40 msec less than or equal to 20 microvolts) was detected in 5 pts (group A, 11%) while 39 pts (group B, 89%) had a normal signal-averaged electrocardiography. Ventricular tachycardia runs at dynamic ECG were present in 2 pts in group A (40%), and in 8 in group B (21%, p = NS). No statistical differences were found between the two groups for any clinical or instrumental data. During our study, one group A patient died suddenly. In detecting subjects with ventricular tachycardia runs, signal-averaged electrocardiography sensitivity was 20%, and specificity was 91%. High specificity suggests that signal-averaged electrocardiography might be used to detect pts at a lower risk for ventricular tachycardia. Further investigations are required to evaluate the predictive value of signal-averaged electrocardiography for sudden death in hypertrophic cardiomyopathy.

Adolescent↗
PubMed1990

[Carotid artery occlusion disclosed by cerebral ischemia. Lesional, etiologic and developing aspects].

The authors report on a series of 100 patients, who underwent an ischemic cerebrovascular accident (CVA) (8 transient attacks, 15 minor CVAs and 77 completed strokes) which revealed internal carotid artery occlusion (unilateral in 93 cases and bilateral in 7), proven by ultrasonography and/or angiography. The computerized tomography scan was normal in 8 cases. The middle cerebral artery territory was involved in 84 patients (isolated or associated (25 patients) with another site), whereas an isolated watershed infarction was the only lesion in the other 8 patients. Twenty-two patients died during the acute phase. Among the 68 survivors followed for a long time, 28 were severely incapacitated. The occlusions were not atherosclerotic in 18 cases (8 spontaneous dissections, 5 cardiogenic emboli, 3 radiation-induced arteries, 2 multiple causes). Eighty-two patients had atherosclerotic thromboses (67 men and 15 women, mean age 63.1 +/- 12.7 years). Among them, 24 had previously experienced minor ischemic strokes. In this group, the two year survival rate was 63 p. 100. Patients with non-fatal atherosclerotic thromboses were followed for an average of 22.2 months, during which time 28.2 p. 100 experienced another stroke.

Actuarial Analysis↗
PubMed1990

Plasma fibronectin: a study of 340 assays.

The authors report the results of 322 assays of plasma fibronectin. The object of this study was to specify its diagnostic contribution. The assays have been effected from February 1987 to October 1988 by the laser nephelometric method in all the hospitalized patients without exclusion. We have defined two populations on clinical diagnostic criteria into 193 control cases and 129 patients suffering from inflammatory rheumatisms or bone neoplasias. The statistical processing has been effected in the Department of Medical Computer Science. The results are as follows: The rate of plasma fibronectin is inclined to increase with age (p = 1 X 10(-4) a little higher among men than among women (p = 0.05). With regard to the other biological markers of inflammation, there was no obvious correlation with the rate of fibrin, the sedimentation rate at the first hour, or the presence of C-reactive protein. This study does not confirm the specificity of this assay in the inflammatory rheumatisms although our two populations are strictly comparable with respect to age and sex, and the clinical and biological parameters (sedimentation rate and fibrin) would allow us to discern the difference, if any, between the two populations. Plasma fibronectin assay has no diagnostic or discriminating value on a large scale.

Aging↗
PubMed1989

Severity of arrhythmias and extent of hypertrophy in hypertrophic cardiomyopathy.

To evaluate the relationship between the extent of left ventricular hypertrophy and ventricular or atrial arrhythmias, 77 patients with hypertrophic cardiomyopathy underwent two-dimensional echocardiography and 24-hour Holter monitoring. Antiarrhythmic treatment was discontinued before the study. Hypertrophy was septal in 33 patients, "extensive" (i.e., involving the septum and free wall) in 38 patients, and predominantly apical in six patients. Lown grade I and II ventricular arrhythmias were detected in 37% of patients, grade III in 21%, and grade IV in 29%. Atrial extrasystoles were seen in 52% of patients and chronic atrial fibrillation in 13%. More serious ventricular arrhythmias (Lown grades III and IV) occurred significantly more frequently in patients with extensive than in those with only septal hypertrophy (22/38 vs 11/33; p less than 0.001); similarly, chronic atrial fibrillation occurred more commonly in those with extensive hypertrophy (9/38 vs 1/33; p less than 0.01). During a mean follow-up period of 2.6 years, three patients died. All had a pattern of extensive hypertrophy. Two of them had ventricular tachycardia and the third had chronic atrial fibrillation. Results of this study suggest that an echocardiographic finding of extensive hypertrophy represents a useful marker for detecting patients at increased risk for serious ventricular and atrial arrhythmias.

Adolescent↗
PubMed1989

Dilated cardiomyopathy with regional myocardial hypoperfusion in Becker's muscular dystrophy.

We describe two cases of Becker's muscular dystrophy, both of which presented with a dilated cardiomyopathy with alterations of myocardial perfusion and hypokinesia in the anteroseptal and apical ventricular walls. To the best of our knowledge, only one case with similar cardiologic characteristics has been reported previously. Myocardial involvement in this disease is comparable to that found in the Duchenne form of dystrophy. The possible mechanisms underscoring its induction are discussed.

Adult↗
PubMed1989

Uterine carcinosarcoma. Case report.

The authors describe the clinical and pathologic features of uterine carcinosarcoma. In the case of a 45 year old patient the rarity of this double tumor is pointed out.

Carcinosarcoma↗
PubMed1989

[Syndrome X].

The authors reviewed the literature on X syndrome, finding criteria of inclusion/exclusion so different as to often invalidate the results. The syndrome should be diagnosed only in patients with typical anginal pain on effort relieved by nitroglycerin or rest, with perfectly regular coronary vessels and a normal resting left ventricle, without any evidence of variant angina. Other diseases must be strictly excluded (mostly at the esophageal level) and an ischemic process has to be proved by means of more than one provocative test. Interesting pathophysiological findings are the dynamic limitation of coronary flow reserve and frequent reports of a left ventricle dysfunction during stress. Whether these last findings represent an independent entity, an aspect or stage of the variant angina or the initial appearance of a cardiomyopathy, has yet to be clarified. Frequent reports of a higher prevalence of X syndrome in women have not been substantiated and could be explained by many biases.

Angina Pectoris↗
PubMed1988

[Efficacy of verapamil in the prevention of ventricular fibrillation in the acute phase of myocardial infarction].

The effectiveness of verapamil in preventing ventricular fibrillation caused by coronary occlusion or reperfusion has been well demonstrated in animal studies, but these experimental data have not yet been confirmed in man. In this study we evaluated the prevalence of ventricular arrhythmias (fibrillation, sustained tachycardia and frequent extrasystoles) in patients hospitalized for myocardial infarction and treated with or without verapamil. The records of patients admitted to our Coronary Intensive Care unit during a 5-year period were analyzed retrospectively. Strict selection criteria enabled us to divide our patients into two homogeneous groups. The control group (group A) consisted of 106 patients who received only continuous infusions of heparin. The treated group (group B) comprised 89 patients who received exclusively verapamil by intravenous injections followed by continuous infusions. The prevalence of ventricular arrhythmia of all types was significantly lower in group B (22 p. 100) than in group A patients (71 p. 100; p less than 0.001). Episodes of ventricular fibrillation, in particular, were considerably less frequent in group B patients (1 p. 100) than in group A patients (13 p. 100; p less than 0.001). It would appear from these results that verapamil is highly effective in preventing death due to cardiac arrhythmia in the acute phase of myocardial infarction.

Cardiac Complexes, Premature↗
PubMed1988

[Tricuspid endocarditis caused by Staphylococcus aureus in AIDS. Discussion of a case].

Right-sided staphylococcal endocarditis has been described in drug-addict, but not in association with an Acquired Immunodeficiency Syndrome. A case of a 26 years old drug-addict woman with AIDS related complex is reported. Antibiotic therapy, produced a favourable evolution on the illness. This case support the usefulness of two-dimensional echocardiography for detecting one of the possible complications associated with AIDS.

AIDS-Related Complex↗
PubMed1987

Body surface maps in left bundle branch block uncomplicated or complicated by myocardial infarction, left ventricular hypertrophy or myocardial ischemia.

We provided a topographic and quantitative description of body surface maps (BSM) during the entire QRST interval in seven uncomplicated LBBBs and 31 LBBBs complicated by: myocardial infarction (MI, seven cases), left ventricular hypertrophy (LVH, eight cases), myocardial ischemia (IS, seven cases), MI + LVH (six cases) and LVH + IS (three cases). In all patients we observed abnormal map configurations attributable to the LBBB. We were unable to identify consistent effects of the complicating heart condition(s) on the general pattern of chest potentials. Conversely, the surface voltages were generally decreased by MI and IS and increased by LVH. By considering the 38 patients as a preliminary learning set we applied a stepwise discriminant analysis to 77 voltage-related variables derived from BSM to produce a model for discriminating between LBBBs with and without MI. We properly allocated more than 90% of the patients. We also attempted to classify the patients into four groups: pure LBBB, LBBB + MI, LBBB + LVH and LBBB + IS, with a percentage of correct classification of about 80%. The two classifying procedures were applied to ten new LBBB patients with results similar to those obtained in the 38 of the study group.

Adult↗