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Biomedical subjects

G Macchia

Publications and source records attributed to G Macchia.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Role of ultrasonic diagnosis as a complementary method in contrast radiography of the intestines].

This study was aimed at evaluating US reliability and sensitivity in identifying inflammatory or neoplastic bowel diseases in symptomatic patients. Two hundred and fifty patients who had been referred to our Unit for double-contrast barium enema of small bowel and colon, underwent panoramic and targeted abdominal US. According to well-known pathological criteria--i.e., intestinal wall thicker than 5 mm, and pseudo-kidney pattern--US had 61.7% sensitivity for inflammatory and neoplastic bowel diseases. The results indicate that US findings negative for intestinal disease are not reliable unless confirmed by contrastographic and endoscopic examinations. However, panoramic US occasionally demonstrated intestinal abnormalities and allowed collateral diseases to be observed in other organs or apparatuses. These abnormalities had been missed at contrastography, and were sometimes responsible for the symptoms the patients complained of. Targeted US emerged as a useful tool for detailing the lesions demonstrated by double-contrast barium enema, especially in case of expansive pathologies (size of the mass and relationship to adjacent organs).

False Negative Reactions↗
PubMed1986

The murine interleukin 1 beta gene: structure and evolution.

We have isolated from a genomic library a murine recombinant clone containing the gene coding for interleukin-1 beta m-RNA. A 7000 b.p. DNA fragment has been sequenced. Sequences homologous with human IL-1 beta cDNA have been found distributed within 7 exons. The translation of these sequences allows the prediction of a protein 269 aminoacids long. Hybridization of P388D1 RNA from cells stimulated with phorbol myristic acetate with a genomic DNA probe shows the existence of a 1.6 Kb murine IL-1 beta mRNA which is absent in the unstimulated cells. The comparative analysis between the murine IL-1 beta and the human IL-1 alpha genes shows extreme conservation of the aminoacids at the exon junctions. This observation together with the similarity in number and size of the exons suggests that these genes have diverged from a common ancestor.

Amino Acid Sequence↗
PubMed1986

[Chronic renal insufficiency associated with tuberous sclerosis].

Despite the high incidence of renal involvement by hamartomatous proliferative lesion, the occurrence of chronic renal failure in patients with tuberous sclerosis in unusual. This rare association in a 37 year old woman is described. The literature is reviewed and the pathological, clinical, diagnostic and therapeutic aspects of this entity are discussed.

Adult↗
PubMedDate not supplied

Hyperfibrinogenemia and metabolic syndrome in type 2 diabetes: a population-based study.

BACKGROUND: It has been hypothesized that fibrinogen clusters with several components of the metabolic syndrome, thus increasing its cardiovascular risk. The aims of the present study were to assess in a large population-based cohort of patients with type 2 diabetes (1) variables associated with fibrinogen and (2) the relationship between hyperfibrinogenemia, a number of components of the metabolic syndrome, and coronary heart disease (CHD). METHODS: We identified a cross-sectional, population-based cohort of 1574 patients with type 2 diabetes using multiple sources of ascertainment. Components of the metabolic syndrome were hypertension (systolic blood pressure > or = 160 mmHg and/or diastolic blood pressure > or = 95 mmHg and/or treatment with antihypertensive drugs), dyslipidemia (tryglicerides >2.82 mmol/l and/or HDL-cholesterol <1.03 mmol/l), hyperuricemia (uric acid >416 micromol/l) and increased albumin excretion rate (AER > or = 20 microg/min). RESULTS: Fibrinogen increases with age, HbA(1c), smoking, hypertension and a number of components of the metabolic syndrome, even after adjustment for confounders. Prevalence of CHD increases linearly across quartiles of fibrinogen (from 26.1 to 40.6%, p=0.046). However, in logistic regression, after adjustment for both confounders and known risk factors for CHD, the role of fibrinogen is no more significant, whereas ORs for HbA(1c) between 6.8 and 8.8% and >8.8% vs values <6.8% are, respectively, 1.91 (95% CI 1.36-2.69) and 1.56 (1.07-2.27). CONCLUSIONS: This population-based study shows that fibrinogen increases with age, HbA(1c), smoking, hypertension and a number of components of the metabolic syndrome, independent of major confounders. We also found that poor blood glucose control was associated with CHD.

Aged↗
PubMedDate not supplied

Differential stability of human interleukin 1 beta fragments expressed in yeast.

We have made deletions in a human interleukin 1 beta cDNA cloned in a yeast vector capable of directing the expression and secretion of foreign protein. Deletions at either the 5' or 3' end of the cDNA result in a dramatic drop in yield of protein. An investigation of some possible causes points to instability of the truncated peptides as a major factor contributing to low yield. The results suggest that correct folding of mature interleukin 1 into a protease resistant form requires almost the entire polypeptide.

Base Sequence↗
PubMedDate not supplied

[Preoperative radiochemotherapy in pancreatic cancer: preliminary results].

AIMS AND BACKGROUND: The prognosis of pancreatic cancer remains poor. Surgery, when feasible, is rarely curative. Radiation therapy (RT) and concomitant 5-fluorouracil (5-FU) have been shown to improve survival in locally advanced pancreatic cancer. In an attempt to improve resectability and disease control, we used preoperative chemoradiation in a combined modality therapy protocol. The purpose of this study was to evaluate our initial results in terms of acute toxicity and response. METHODS: From October 1995 to May 1998, 20 patients (11 males, 9 females; mean age, 60.1 years; median follow-up, 28 months) with unresectable (12 patients) or resectable (8 patients) non-metastatic pancreatic tumors, received external beam radiation (39.6 Gy) plus 5-FU (96 hours continuous infusion, days 1-4 at 1000 mg/m2/day). After 4 weeks, patients were evaluated for surgical resection. In resected patients, electron-beam intraoperative radiation therapy (10 Gy) was given before reconstruction. Thereafter, in resected patients, adjuvant chemotherapy was prescribed (6 courses: 5-FU, mitomycin C, adriamicine). RESULTS: During chemoradiation, no patients developed grade 3-4 acute toxicity. Three out of twelve (25%) patients with unresectable tumors had tumor downstaging. No patients showed partial or complete responses. Four out of twenty patients (20%) had minimal tumor response. Three patients showed disease progression after chemoradiation (liver or peritoneal metastases). Nine patients underwent surgical resection and IORT, with 1 postoperative death. The median survival time for the 20 patients was 9.4 (18.5 and 8.3 months in resected and unresected patients, respectively). CONCLUSION: Our preliminary results suggest that preoperative 5-FU chemoradiation was well tolerated and may result in tumor downstaging but the response-rate is still low. Based on the impact of surgical resection on survival, an improvement in local response rate is necessary.

Actuarial Analysis↗
PubMedDate not supplied

Concomitant radiochemotherapy in unresectable carcinoma of the exocrine pancreas: cost-effectiveness analysis.

One of the principal therapeutic options in unresectable carcinoma of exocrine pancreas is concomitant radiochemotherapy. However, in current scientific literature cost analyses of this therapeutic modality are lacking. A payer-oriented cost-effectiveness analysis of concomitant radiochemotherapy was carried out. Outcomes and differences in costs relatively to two different therapeutic strategies were compared retrospectively: biliary drainage + observation (group 1); biliary drainage + concomitant radiochemotherapy (group 2). Cost-effectiveness was assessed based on the analysis of incremental cost of benefit in terms of survival in group 2. As incremental cost of group 2 was considered that of radiochemotherapy, costs of diagnosis and staging being similar in the two groups. The unit of measurement used was $/Lys (LYS = years of life saved). For estimates of cost-effectiveness in different clinical situations, a sensitivity analysis was carried out. The incremental cost of standard concomitant radiochemotherapy was shown to be $4,755. Incremental costs relatively to the situations of minimum and maximum treatment were shown to be $4,410 and $8,375, respectively. Median survival was 4.5 and 10 months in group 1 and 2 respectively (logrank: p = 0.0046). The benefit in terms of survival achieved by concomitant radiochemotherapy was shown to be 5.5 months equal to 0.46 years. Therefore, in the standard situation, the treatment cost-effectiveness can be estimated in: $4,755/0.46 years = $10,337/LYS, that is, the cost of a year of life saved was shown to be $10,337. Results of sensitivity analysis showed that cost-effectiveness can be estimated in the range $7,603 and $25,379/LYS. In conclusion, concomitant radiochemotherapy in patients with unresectable pancreatic carcinoma is able to improve the quality of life through the relief of related symptoms as well as median survival (10 vs 4.5 months). Costs of these benefits, even if considering better survival only, based on this analysis, were shown to be acceptable.

Adult↗
PubMedDate not supplied

Research trends in the treatment of neoplasms of the exocrine pancreas.

To-date, the therapeutic standards, defined by randomized studies for carcinoma of the exocrine pancreas are disappointing. Obviously, there is much interest in the improvement of these results based on the evidence of additional clinical trials. To identify some trends in the clinical research in this field, some characteristics of 31 ongoing trials, described in the web site of the National Cancer Institute were examined. 28/31 trials are coordinated by Centers of the U.S.A. and 3/31 trials specifically concern symptom palliation. Excluding the latter, 4 trials enroll patients with operable neoplasms, 8 with inoperable tumors, 4 with metastatic neoplasm and 12 involve both latter categories. Four of the 5 phase I or I-II studies concern concomitant radiochemotherapy of inoperable neoplasms; the 16 phase II studies and the 7 phase III studies involve the use of different combined modality therapies in all patient categories. Overall, 18 trials test innovative treatment modalities (new drugs, immunotherapy, monoclonal antibodies). Eight trials include the evaluation of the quality of life between endpoints. Based on this assessment of some of the ongoing clinical trials, hopefully, there will be: 1. a greater interest in the prospective therapies for this neoplasm, especially at the European level, considering the high incidence of this disease; 2. more careful attention to the possibility of downstaging of locally advanced neoplasms considering the present, proven possibility to achieve better clinical responses in pancreatic carcinoma; 3. a more widespread interest in the establishment of parameters for the quality of life, considering the frequently "palliative" intent of available therapies.

Clinical Trials as Topic↗
PubMedDate not supplied

Brain metastasis from colon cancer. Case report showing a clinical and CT unusual appearance.

The authors report the case of a patient harbouring a parietal convexity tumor whose clinical and CT features were suggestive of a meningioma. Unexpectedly the tumor was a well differentiated adenocarcinoma from a colon cancer with a markedly PAS positive intragland content represented by wide areas of mucoid degeneration. Brain metastases from colon cancer are usually late occurrences and it is extremely rare that the brain lesion be discovered while the primary tumor is still unknown. The authors discuss about the pathogenesis of the CT appearance of adenocarcinoma which is, usually, slightly hyperdense. On the basis of the reported findings it is suggested that mucoid degeneration may induce the development of a well defined CT pattern represented by a very high density appearance with no contrast enhancement.

Adenocarcinoma↗
PubMedDate not supplied

[Meningoencephalitis in children and computerized axial tomography. Clinico-prognostic evaluation].

A large casistic of severe CNS infectious diseases in pediatric age was reviewed to underline mean clinic, EEG features and correlated them with CT images. We conclude that CT scanning is useful in CNS infectious diseases, above all in the first life years, because it can provide diagnostic and prognostic information and sometimes therapeutic indication.

Bacterial Infections↗