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Biomedical subjects

I Del Prato

Publications and source records attributed to I Del Prato.

14 recordsLinked to original sources
PubMed2002

[Breast inflammations: clinical observations and principles of treatment].

In this study some clinical and etiopathogenetic principles, and the most appropriate treatment for breast inflammation are discussed. In the majority of cases, differential diagnosis is made not only through clinical diagnosis but also through cytological examination and ultrasonography. Of the forms reported, we considered the different inflammatory, glandular and extraglandular, peripheral and central mastites; among the latter in particular periductal mastitis and duct ectasia. Medical treatment is the answer for some forms, while for others, as for example mammillary fistula, we prefer, in agreement with some authors, the surgery of fistulectomy and healing by first intention; for the peripheral abscesses we prefer US-guided percutaneous drainage. This article stresses the importance of clinical diagnosis, pathogenetic history, and adequate treatment in efforts to improve both the knowledge of the surgeon and the quality of life of the patient.

Female↗
PubMed1997

Ambulatory narrow excision for thin melanoma (< or = 2 mm): results of a prospective study.

Although narrow surgical excision may be sufficient for thin melanoma, questions remain concerning how narrow the excision should be and how it should be related to tumour thickness. To address these issues, a group of 168 consecutive patients with primary invasive melanoma up to 2 mm thick underwent ambulatory surgery with excision margins of 1 cm. 40 (24%) of these patients had lesions thicker than 1 mm. In a median follow-up of 5 years, 11 patients relapsed and 3 developed second malignancies. The crude cumulative incidence of regional and distant metastases were, respectively, 5.6% and 1.5%. No local isolated recurrence was observed, indicating that ambulatory narrow excision is justified for melanoma up to 2 mm thick.

Ambulatory Surgical Procedures↗
PubMed1995

In vivo spectrophotometric evaluation of neoplastic and non-neoplastic skin pigmented lesions. III. CCD camera-based reflectance imaging.

Reflectance spectroscopy, which allows an objective evaluation of the color of surfaces, has recently been proposed as a useful tool to discriminate cutaneous melanoma from other pigmented cutaneous lesions. A novel spectrophotometric system based on the use of a charge coupled device camera provided with a set of interference filters has been developed to acquire images of cutaneous pigmented lesions at selected wavelengths ranging from 420 to 1040 nm. For each filter, an image was captured, digitized by a frame grabber and stored in a personal computer to perform off-line data handling. Reflectance images were acquired of 22 cutaneous pigmented lesions including melanoma and dysplastic, compound and junctional nevus. From each spectral image, three parameters, i.e. mean reflectance, variegation index and lesion area; were derived at the corresponding wavelength. The wavelength dependence of the three parameters was significantly different when melanoma was compared to the other investigated lesions. Although preliminary, our results suggest that telespectrophotometry gives useful information and could be utilized as an aid in the clinical diagnosis of cutaneous pigmented lesions.

Humans↗
PubMed1994

Childhood cutaneous melanoma.

Seventeen consecutive patients no older than 14 years with cutaneous melanoma were observed from 1975 to 1991 at the Istituto Nazionale Tumori, Milan; this series represented 0.8% of all cutaneous melanomas observed at the Institute during this period. Ten were males and seven females. Nine lesions arose on limbs, seven on the trunk, and one on the head and neck area. Reexamination of the clinical records suggests that childhood melanoma may present with unusual characteristics such as unusual appearance of the primary lesion and lack or scarcity of pigmentation. At first observation ten patients had stage I disease nine underwent surgery alone while in one surgery was performed in combination with regional lymph node dissection and chemotherapy. All the stage II patients underwent excision of the primary lesion and lymph node dissection. One of the 2 stage III patients received lymph node dissection only, and the other no treatment. Analysis of this series of 17 cases does not indicate that cutaneous melanoma in children is more aggressive than in adults. It is stressed that, although rare, the physician should be aware that cutaneous melanoma may occur in prepuberty.

Adolescent↗
PubMed1994

Acral lentiginous melanoma. A histological type without prognostic significance.

BACKGROUND: Acral lentiginous melanoma (ALM) is reported to have a poorer prognosis than melanomas of other histotypes. OBJECTIVE: The purpose of this paper is to verify if ALMs, per se, have a more aggressive behavior or if the poorer prognosis of these patients is due to a later diagnosis. METHODS: Clinical charts of 165 patients with acrally located melanoma were reviewed as well as all histological slides. In all patients, histotype, Clark's level, Breslow thickness, pigmentation, presence of ulceration, and regression were reported. Mitotic index, vascular invasion, and microscopic satellitosis were also determined. Survival of the 64 patients with ALM was compared with survival observed in the remaining 101 acral (nonlentiginous) melanomas. RESULTS: Melanoma localized at acral sites constitute 8.9% of the 1845 patients with melanoma treated at our Institute from 1975 to 1990. All were Caucasian, 57 were males, and 108 females. Out of the 165 patients with this localization, 64 (38.8%) were classified as ALM. Disease-free and overall survival of the 64 ALM patients were not different at a statistically significant level compared with the areas observed in the other acral nonlentiginous melanoma. CONCLUSION: The survival difference between ALM and other histological types is due to a later diagnosis and not to a more aggressive behavior of ALM.

Disease-Free Survival↗
PubMed1993

Surgical resection plus tamoxifen as treatment of breast cancer in elderly patients: a retrospective study.

Between March 1982 and May 1989, 151 women with primary breast cancer ranging in age from 70 to 91 years (median 79), were treated with conservative surgical procedure followed by adjuvant tamoxifen. Surgery was performed under local anaesthesia without axillary node dissection. The median duration of follow-up was 60 months (range 36-124). There were six local, six ipsilateral axillary node and six distant relapses. Local recurrences were successfully managed with further surgery whereas axillary node relapses required radiotherapy in 3 cases, surgery in 2 cases and hormonal treatment in 1 case. 2 patients died of progression of disease and one of unrelated conditions. The 5-year relapse-free survival rate was 0.82. This treatment option in elderly patients yields an acceptable local control and reduces the risks of major surgery.

Aged↗
PubMed1992

Cationic content in multiple mammary cysts.

One hundred and ninety-six breast cyst fluid samples from 78 consecutive patients with multiple cysts were subdivided according to the K+/Na+ ratio: type 1 (K+/Na+ ratio > 1) and type 2 (K+/Na+ ratio < or = 1). Cysts of the same type were found in 57.7% of patients (concordant group). Such a finding suggests that in patients bearing multiple cysts, all aspirated fluids need to be classified on the basis of their cationic composition. In the concordant group, type 1 cysts were more frequent than in the discordant group (80.3% vs 59.5%, P = 0.002). High K+/Na+ ratios (> 4.0) were present in 64% of type 1 cysts in the concordant group compared to 37.7% in the discordant group (P = 0.001), which suggests a different activity of the epithelium lining the cyst wall.

Adult↗
PubMed1992

Treatment of breast cancer in elderly women: retrospective analysis of 111 wide lumpectomies performed in a day hospital regimen between 1982 and 1988.

Between 1982 and 1988, 111 elderly women with breast cancer but without clinical involvement of the axillary lymph nodes underwent wide lumpectomy in a Day Hospital regimen at the National Cancer Institute of Milan. The patients ranged in age from 70 to 92 years (median, 79). An adjuvant treatment was carried out in all but 9 cases: tamoxifen only in 84 cases, tamoxifen plus radiotherapy in 6 cases, radiotherapy alone in 12 cases. The median duration of follow-up was 44 months (range, 30-109 months). Four patients (3.6%) were lost to follow-up. In the remaining 107 patients, 10 local-regional relapses (9.1%) and 7 distant metastases (6.5%) occurred. Six patients died from the disease, 14 from unrelated conditions. This retrospective study showed that selected elderly patients with breast cancers can be treated successfully under local anesthesia on an outpatient basis. The treatment guarantees local control of the disease, meets the favor of elderly women and consequently improves their quality of life.

Actuarial Analysis↗
PubMed1992

The role of fine needle aspiration in the diagnosis of thyroid nodules: analysis of 795 consecutive cases.

The utility of fine needle aspiration (FNA) and physical examination for selecting patients with palpable thyroid nodules for surgery was evaluated in 795 consecutive cases. Surgery was performed in 216 patients based upon the cytological diagnosis and clinical criteria. Excluding 42 patients who were lost to follow-up, the remaining 537 were regularly followed up (range, 2-10 years). Cytological findings were classified as malignant, histologic control recommended (suspicious), follicular tumor, benign, and unsatisfactory. Thirty-six aspiration biopsies were positive for malignancy and the diagnosis was confirmed histologically in 34 of them. In 65 patients with final histological diagnosis of malignancy, cytology was positive in 34, suspicious in 20, benign in 3 cases, and unsatisfactory in 8. All patients with cytological diagnosis of follicular tumor had a benign lesion at histology. There were two false positive and three false negative cytological results among the 216 histologically confirmed cases. Excluding unsatisfactory specimen sensitivity, specificity and the predictive value for a positive and a negative result were respectively 95%, 97.5%, 94.5%, and 97%. We conclude that FNA is a very reliable diagnostic test in the evaluation of thyroid nodules and is the best guidance in addition to clinical criteria for selecting patients to be submitted to surgery.

Adenoma↗
PubMed1992

Classic Kaposi's sarcoma: a review of 90 cases.

A series of 90 cases of classic Kaposi's sarcoma observed and treated over the last 25 years was examined retrospectively. Fifty-one were the localized and 39 the disseminated form. Outpatient surgery for the localized and vinblastine chemotherapy for the disseminated form are probably the best treatments. Radiotherapy may be a valid alternative.

Adolescent↗
PubMed1991

Accumulation of active androgens in breast cyst fluids.

80 breast cyst fluids (BCF) from 57 patients were divided by K+/Na+ ratio: 56 with ratio over 1 (type I) and 24 with ratio less than 1 (type II). Significantly higher amounts of testosterone, dihydrotestosterone and dehydroepiandrosterone sulphate (DHAS) were found in type I than in type II cysts. A positive relation was found between testosterone and dihydrotestosterone in both types. DHAS was significantly correlated with testosterone and dihydrotestosterone in type I casts only. In 52 patients, blood was sampled after cyst evacuation. Testosterone was significantly higher in blood than in BCF while dihydrotestosterone and androstenedione were significantly higher in BCF. No relation was observed between circulating levels of androgens and their intracystic concentrations. Women bearing type I cysts may be at increased risk of developing cancer. These findings support the hypothesis that androgens play a role in the hormonal aetiology of breast cancer.

Adult↗
PubMedDate not supplied

In situ and very thin melanomas (< 0.75 mm) are similarly and commonly recognizable.

AIMS AND BACKGROUND: Recent data have suggested that cutaneous melanoma in situ can be clinically recognized in most cases by its features, which resemble those of early invasive melanoma. The aim of the study was to verify whether the diagnostic sensitivity of melanoma in situ is actually equivalent to that of early invasive melanoma. METHODS: We retrospectively reviewed the clinical diagnosis of 274 consecutive cutaneous melanoma < 0.75 mm thick. The series consisted of 84 in situ and 190 invasive lesions. RESULTS: The clinical diagnosis of melanoma was performed in 62% (52/84) of cases of in situ melanoma and in 68% (130/190) of the cases of invasive melanoma. The differences were not statistically significant. CONCLUSIONS: Our results show that cutaneous melanoma can be clinically diagnosed at a very early stage. In situ and very thin melanomas (< 0.75 mm) are similarly recognizable.

Aged↗