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Biomedical subjects

G Castelli

Publications and source records attributed to G Castelli.

At least 55 records · Page 3Linked to original sources
PubMed1986

Hydroxyurea and 6-mercaptopurine in the treatment of chronic granulocytic leukemia.

From 1975 to 1981, 92 patients with newly diagnosed Ph'-positive chronic granulocytic leukemia entered two consecutive studies. The initial trial (Study I, 1975-1978) tested the efficacy of hydroxyurea (HU) as single agent in 45 consecutive patients. In an effort to improve results obtained with HU alone, from 1978 to 1981, 47 new patients entered a second trial (Study II), which consisted of a continuous treatment with a combination of HU and 6-mercaptopurine (6-MP), at doses adjusted so as to maintain the leukocyte counts between 4 and 12 X 10(9)/L. The aim of this second study was to prolong the duration of chronic phase (CP) by the addition of 6-MP to HU and by a stricter continuous control of the size of the total granulocytic mass (TGM). Both regimens were well tolerated. Median duration of CP was 43 months in Study I and 41 months in Study II. Median survival was 51.5 months and 45 months respectively. These data indicate that neither the addition of 6-MP to HU alone, nor the effort to keep a smaller TGM, play a substantial role in postponement of blastic transformation in CGL.

Adult↗
PubMed1986

[Alcoholic cardiomyopathy in the preclinical stage: non-invasive clinico-instrumental research study on 112 chronic alcoholics].

112 consecutive asymptomatic patients who assumed alcohol in excess (1-2 g/kg/die) for 5 years or more were admitted to our hospital for detoxication. They were examined both clinically and with chest x-rays, ecg, phonocardiography, external pulse recording, and M-mode/2-D echocardiography to detect myocardial involvement. Heart disease not related to alcohol abuse was found in 6 cases. In the remaining 106/112 patients electrocardiographic abnormalities (aspecific ST-T changes, left bundle branch block, intraventricular conduction defects, left ventricular strain pattern and atrial fibrillation) were present in 18 per cent of cases. PEP, LVET intervals and PEP/LVET, were calculated only in 39/106 patients and did not differ significantly from the control group. The echocardiographic study showed hypokinesis and left ventricular dilatation in 9/106 patients. In other 5 cases echocardiographic findings were at upper limits of normal for left ventricular dimension and motility. Therefore in 13 per cent of cases a dilated cardiomyopathy was revealed by the echocardiographic study. In 6 of these 13/106 patients ecg was either normal or showed only aspecific ST-T changes. Echocardiography failed to confirm augmented left ventricular thickness and mass as reported in asymptomatic alcoholic patients in the literature. Probably several factors (different interval of time between the interruption of the alcoholic abuse and the time of examination, the quantity of alcohol in excess and the echocardiographic technique) may influence the results of such studies. The present report nevertheless points out to the validity of the echocardiographic study in the detection of subclinical myocardial involvement in alcoholic patients and should be performed in such cases.

Adult↗
PubMed1985

Immunoblastic lymphoma: a clinicopathologic study with emphasis on the cases intervening during or following other disorders.

Fifty-eight patients with immunoblastic lymphoma (IBL) were the object of this study. Fifteen of them (26%) developed IBL during or after other diseases, either immunologic or neoplastic, including angio-immunoblastic lymphadenopathy, autoimmune disorders, chronic lymphocytic leukemia, Waldenström's disease, lymphoplasmacytoid lymphoma and Hodgkin's disease (subsequent IBL). The comparison between de novo and subsequent IBL revealed a significantly higher incidence of bone marrow involvement and bulky abdominal disease in the latter group, with a lower response rate to chemotherapy. The favorable primary extranodal disease of Waldeyer's ring exclusively belonged to de novo IBL, whereas the frequency of immunoglobulin abnormalities was higher in the subsequent IBL group (67%). The stage of disease, systemic symptoms at diagnosis and response to therapy were predictive of survival. The overall complete remission (CR) rate in the whole series was 37% and the median overall survival 14 months. Complete remitters have a median survival in excess of 60 months; all relapses occurred within the first 12 months of CR. No CNS relapse terminated the CR, and CNS prophylaxis seems unnecessary in IBL. The analysis of subsequent IBL may provide information on the pathogenesis of non-Hodgkin's lymphomas; the still poor prognosis of IBL deserves new therapeutic attempts to improve on the standard regimens.

Adult↗
PubMed1985

[Treatment and prevention of postmastectomy lymphedema (our experience)].

The authors consider the incidence of arm lymphedema after mastectomy. Considering the temporary results which come from surgical practices, either from excision operations or lymphovenous anastomosis, they stress out the importance of the prevention measures and of the physiotherapeutic treatment. This is essential to keep lasting as long as possible the results of the operation when it is necessary because of serious functional deficit. Two cases of Thompson's operation are shown.

Female↗
PubMed1984

Oral and intravenous pharmacokinetics of ranitidine in patients with liver cirrhosis.

The kinetics of p. o. (150 mg) and i.v. (50 mg) ranitidine was studied in nine healthy controls and in nine patients with compensated liver cirrhosis. Plasma concentrations and urinary recovery of unchanged drug were determined by high performance liquid chromatography. The pharmacokinetic data observed in the cirrhotic patients did not differ from those of controls after p.o. or i.v. administration. Moreover, oral bioavailability was similar in controls and cirrhotics. In conclusion, the pharmacokinetics of ranitidine is not altered in patients with compensated liver cirrhosis.

Administration, Oral↗
PubMed1983

Low-grade malignancy non-Hodgkin's lymphomas: prognostic relevance of their clinicopathologic heterogeneity.

We reviewed 182 consecutive adult patients with low-grade malignancy, non-Hodgkin's lymphomas classified according to the Kiel classification, followed at the Division of Hematology, Policlinico S. Matteo, Pavia, from January 1975 to December 1981, to recognize, in each histopathologic type, important subgroups from the prognostic standpoint. Median follow-up was 36 months. No significant differences were observed in the response rate to conventional therapy (radiotherapy for localized disease, CVP for advanced stages) between the 4 cytologic types. The centrocytic-centroblastic lymphoma with diffuse nodal architecture showed an intermediate-grade malignancy (median survival, 50 months) and underwent cytologic progression to the high-grade malignancy centroblastic type in 10% of the cases. Large-cell centrocytic and polymorphic lymphoplasmacytoid lymphomas had a poor prognosis (median survival less than 30 months) when treated with conventional therapy for favorable histologies, and 6% of the cases transformed into the high-malignancy immunoblastic type. Patients with lymphocytic lymphoma with bulky mediastinum had a median survival of 20 months. The identification of these subgroups with a worse prognosis may have therapeutic implications.

Adult↗
PubMed1982

Risk of leukemia in patients treated for Hodgkin's disease.

We reviewed 251 consecutive adult patients with Hodgkin's disease treated at the Division of Hematology, Policlinico S. Matteo, Pavia, from January 1970 to December 1979, to assess the risk of development of acute leukemia. The median time of follow-up was 48 months (range 6-135). No leukemia occurred in 88 patients treated with radiotherapy or chemotherapy alone. Six acute non-lymphoid leukemias occurred in the group of 163 patients treated with MOPP and radiotherapy (crude rate of leukemia of 7.5 per 1000 person-years at risk). All cases were in clinical remission and off therapy; the latent period from initiation of therapy to onset of leukemia ranged between 30 and 90 months. The actuarial probability of leukemia at five and seven years was 2.9 and 4.7% for the entire group of patients, and 3.8 and 5.8% for the combination therapy group. All leukemias , except one, had a preleukemic phase lasting 1-12 months, with cytopenia and dysplastic marrow. The median survival after leukemia was 4.7 months.

Adult↗
PubMed1982

Adult acute lymphoblastic leukemia. Response to therapy according to presenting features in 62 patients.

Sixty-two adult patients with acute lymphoblastic leukemia (ALL) were treated with an induction regimen including vincristine, daunorubicin and prednisone (VDP) followed by CNS prophylaxis. Forty-five patients (72.5%) achieved complete remission (CR). The CR were maintained with daily 6-MP and weekly MTX. Monthly reinduction cycles with vincristine and prednisone (plus daunorubicin every three courses) were also given. Median duration of CR was 10.4 months. Overall survival was 17.4 months. The remission rate and length of CR were studied in relation to the clinical and hematological features present at diagnosis. CR rate was adversely influenced by age only over 40 and by tumoral presentation. The length of remission was negatively influenced by tumoral presentation, CNS involvement, high circulating blast count, L2 and L3 cytology, and T or B immunological phenotype. Multiple regression analysis confirmed the weight of FAB morphology in determining the length of remission. Among L2 adult patients, tumoral presentation appears to be the major unfavourable prognostic factor.

Adolescent↗
PubMed1981

Antitoxoplasma antibodies in mothers in labour and their newborn children.

A serological investigation on antitoxoplasma antibodies of women in labour and their newborn babies was carried out on a population sample representative of a defined geographical area. The relevant findings revealed: a) high titer antibodies in 21.2% of parturient-newborn pairs; b) slight or non-apparent toxoplasma infection, limited to 2.4% of newborns with high titer antibodies; c) quick drop of antibody titer in two thirds of seropositive women in labour observed 90 days from childbirth; d) a steady proportion of seronegative pregnant women - 40% ca. - detected in all age groups from 20 and 40 years and over. These findings are discussed, and assumptions on their meaning are put forward.

Adult↗
PubMed1980

The association of eosinophilia with lymphoblastic leukaemia or lymphoma: a study of seven patients.

Seven patients with hypereosinophilia in association with a lymphoblastic malignancy are described. The eosinophilia preceded or was present at diagnosis in all patients. Eosinophil counts fell during complete remission but rose significantly before or during relapses in five patients. Hypogranular and sometimes Pelger-eosinophils were seen in five cases. Surface and enzyme markers defined the malignancy in six cases as common-ALL (three), T-ALL (two) and T-lymphoblastic lymphoma (one). Although a diagnosis of eosinophilic leukaemia or acute myeloid leukaemia with eosinophil differentiation was considered in three patients, cytochemical and ultrastructural studies failed to show any evidence of myeloid differentiation in the blast cells. The bone marrow karyotype was normal in the four patients studied. All seven patients had one or more relapses and six died 6-62 months from diagnosis. Severe complications of the hypereosinophilic syndrome developed in one patient. As T-lymphocytes have been shown to be involved in the induction of eosinophilia in rodents, it is suggested that the hypereosinophilia in these patients was induced by eosinopoietic stimuli produced by lymphoblasts.

Adolescent↗
PubMed1977

[Result of an antifibrinolytic treatment using tranexamic acid for the reduction of blood-loss during and after tonsillectomy].

Blood loss during and after tonsillectomy was assessed in 80 patients, 40 of whom were treated with tranexamic acid. A statistically significant reduction of blood loss (28%) was observed in this group during operation. Later bleedings occurred only in 27.5% (control: 67.5%) and stopped after 2 h (mean of control: 5.6h). Bleedings in the tranexamic acid group were mild and scarcely required other hemostyptic treatment, while in the control group some patients had to be treated with etamsylate or fibrogen for a longer period to stop bleeding. Tranexamic acid appears to be an effective and well-tolerated agent for reduction of blood loss caused by local hyperfibrinolysis.

Adolescent↗