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Biomedical subjects

G Ciravegna

Publications and source records attributed to G Ciravegna.

At least 19 recordsLinked to original sources
PubMed1997

Multicyclic, dose-intensive chemotherapy supported by hemopoietic progenitors in refractory myeloma patients.

Attempts to increase dose intensity have been hampered by hematologic toxicity. To address this issue, we designed a study to determine whether the reinfusion of PBPC significantly reduces the toxicity of multicyclic dose-intensive chemotherapy. Thirty refractory patients, median age 63, received CY 3 g/m2 plus melphalan 60 mg/m2 followed by PBPC and G-CSF (CM regimen). CY (at day 0) and G-CSF were used to mobilize PBPC harvested by a single leukapheresis at day 10. Melphalan was infused at day 11. PBPC were kept unprocessed at 4 degrees C for 48 h and reinfused at day 12. This regimen was repeated three times every 6 months. Outcomes were compared with those of 30 similar patients treated with melphalan 30 mg/m2 followed by G-CSF only, and repeated every 2 months for a total of six cycles. In patients receiving CY plus melphalan followed by PBPC reinfusion, the median duration of neutropenia (ANC < 500/microliters) and thrombocytopenia (platelets < 2500 microliters) was only 5 and 2 days respectively, and did not increase after the subsequent courses. Hematologic toxicity was quite similar to that observed after melphalan 30 mg/m2 plus G-CSF. The CM regimen was followed by 30% complete remission and 86% response > 50%, melphalan 30 mg/m2 by no complete remissions and 38% response > 50%. Patients receiving CM regimen showed a longer progression-free survival (22 vs 10 months, P < 0.01). The dose intensity of melphalan can be doubled by reinfusing PBPC without increasing toxicity. The combination of CY and melphalan followed by PBPC improves response rate and outcome when compared to low-dose melphalan.

Aged↗
PubMed1996

Combined differentiating therapy for myelodysplastic syndromes: a phase II study.

An in vitro synergism between different inducers of AML cell differentiation has been previously observed. Therefore, we treated 53 myelodysplastic (MDS) patients with a low dose combination of cis-retinoic acid (cRA, 20-40 mg/day) and 1,25 alpha (OH)2 cholecalciferol [(OH)2D3, 1-1.5 micrograms/day] +/- intermittent 6-thioguanine (30 mg/m2/day). The latter was reserved for patients with bone marrow (BM) blast excess (> or = 5%). The treatment was well tolerated, without major toxicity. Among 25 patients with BM blasts less than 5%, we observed one complete, eight partial and four minor responses (response rate 52%) with a median response duration of 8 months (2 +/- 24). Median survival, which did not correlate with response, is projected at 76 months. Thirty-one patients with BM blast excess (> or = 5%), including three of the previous group who progressed to refractory anemia with excess of blasts (RAEB), were treated with the three-drug protocol. One complete, 12 partial and six minor responses were obtained (response rate 61%) with a median response duration of 6 months (2-29+). A significant difference in survival (P < 0.005) was observed between the 19 responders (median 25 months) and the 12 non-responders (median 9 months). A reduction in the transfusion need was observed in 41% of the transfusion-dependent patients with blast excess and in 53% of those without blast excess. Therefore, combined differentiating therapy seems more effective than previously reported single agent treatments and should be considered for a larger randomized study to assess its actual impact on survival of MDS patients.

Aged↗
PubMed1995

No effect of long-term treatment with pancreatic extract on recurrent abdominal pain in patients with chronic pancreatitis.

BACKGROUND: This study was aimed to investigate the effect of long-term treatment with high-protease pancreatic extract on the recurrent abdominal pain of patients with chronic pancreatitis. METHODS: Twenty-six patients with a firm diagnosis of chronic pancreatitis and a pattern of recurrent pain were recruited and randomly assigned to treatment with pancreatic extract (Pancrex-Duo capsules, each containing 34,375 USP units of protease in enteric-coated microspheres) or placebo, at a dose of four capsules four times daily, for 4 months. At the end of the first period patients were switched to the other medication for the next 4 months. Four patients did not complete the study because of unbearable recurring pain or inadequate compliance with treatment. The other 22 patients daily recorded the presence, intensity, and duration of pain and the consumption of analgesics, for 8 months. RESULTS: No difference was found when intraindividual records during placebo and extract treatment periods were compared. Conversely, in the second 4 months of follow-up, regardless of the treatment given in the first period, there was a significant reduction in the cumulative pain score (median, 95; range, 0-1005, versus 134; 0-972; p < 0.05), in the number of days (8; 0-132, versus 13; 0-126; p < 0.02) and hours (54; 0-680, versus 80; 0-602; p < 0.05) of pain, and in the analgesic consumption score (0; 0-22, versus 12; 0-44; p = 0.02). CONCLUSIONS: Chronic supplementation with pancreatic extract is not beneficial in the management of recurrent pain in patients with chronic pancreatitis.

Abdominal Pain↗
PubMed1986

Aortic dissection at autopsy: a fifty-four year survey in Torino.

The Authors reviewed the postmortem findings of 36,671 autopsies performed from 1929 to 1982 in the hospitals of Torino with emergency ward. Two hundred and sixty-five cases of Aortic Dissection (A.D.) were found, and studied in relation to their frequency by sex and age, pathology, and antemortem diagnosis. The main outcome of this survey was the increasing frequency of the lesion in the autopsy population during the last 36 years considered, from 1/759 necropsies in 1947-1952, to 1/52 in 1977-1982. These data are discussed in relation to the hypothesis of a possible actual increase of A.D..

Adolescent↗
PubMed1984

Percutaneous or laparoscopic needle biopsy in the evaluation of chronic liver disease?

Liver biopsies were performed on 60 patients by means of percutaneous needle biopsy, and immediately after that procedure, during laparoscopy from the right and left liver lobes. The histological diagnoses obtained by examining the percutaneous biopsies were found to overlap with the final one that was based on an evaluation of all three liver biopsies. Moreover, highly significant correlation was found to exist between the scores of histological parameters of inflammation, fibrosis, necrosis, and steatosis.

Adult↗
PubMed1983

One or two liver biopsies during laparoscopy?

"Laparobiopsies" were taken from the right and left liver lobe of 57 patients. Despite some minor discrepancies, the histologic diagnoses "overlapped" in most cases. Moreover, a highly significant correlation was detected between the scores of histologic parameters (inflammation, fibrosis, necrosis and steatosis) evaluated in the two series of biopsies.

Adult↗
PubMedDate not supplied

Erosive lichen planus and cirrhotic hepatitis.

Five out of seven patients with erosive lichen planus were found to have cirrhotic liver complications. In 2 patients active chronic hepatitis was proven by means of laparoscopy and liver biopsy.

Chronic Disease↗