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Biomedical subjects

L Ferri

Publications and source records attributed to L Ferri.

At least 19 recordsLinked to original sources
PubMed2005

Management of spontaneous perforation of esophageal cancer with covered self expanding metallic stents.

Optimal management of esophageal perforation is controversial, especially in the presence of malignancy. Esophagectomy has traditionally been employed for patients with malignant perforations. However, in patients with advanced disease, other less invasive treatment options may be of benefit. We present two cases of spontaneous perforation of advanced esophageal cancer successfully managed by insertion of covered self-expanding metallic stents and a review of the literature.

Aged↗
PubMed2004

Tracheomalacia associated with Mounier-Kuhn syndrome in the Intensive Care Unit: treatment with Freitag stent. A case report.

Tracheomalacia is a process characterized by softness of the supporting tracheal cartilages, by the extension of the posterior membranous wall and by reduction of the tracheal antero-posterior diameter. Exceptionally, tracheomalacia can be associated with tracheobronchomegaly or Mounier-Kuhn syndrome. Fibro-bronchoscopy represents the ''gold standard'' for diagnosis. The case of a 79-year-old male observed after hospitalization in a medical ward for chronic pulmonary obstructive disease (COPD) decompensation, and with basal left bronchopulmonary focus, is described. During this period, a progressive worsening of clinical conditions occurred, despite cortisone and antibiotic therapy, and the patient was transferred to the ICU for dyspnea, hypoxia, hypocapnia and with a diagnosis of pulmonary fibrosis. Bronchoscopy, performed during spontaneous breathing, revealed tracheomalacia which was responsible for tracheal dynamic complete stenosis during expiration and dynamic subtotal stenosis of the left primary bronchus in the first tract, together with sputum retention. Moreover, this investigation confirmed the diagnosis of tracheobronchomegaly already seen on CT. It was suggested to place a Freitag stent, since the insertion of another model would not have had enough chance of stability, due to the enormous extension of the tracheal lumen and could not have guaranteed good clearance of the secretions. Seven days after this intervention, performed in an outpatients' setting, the patient was dismissed from the ICU, without the help of O2, with good ventilation, saturation in line with his age and good expectoration.

Aged↗
PubMed2003

Treatment of pseudomyxoma peritonei with two times--cytoreduction and hypertermic antiblastic peritoneal perfusion (HAPP).

Pseudomyxoma peritonei is a rare neoplasia with a low grade of clinical malignity in which neoplastic masses product large amount of mucinous material. Its treatment advocates an aggressive cytoreduction of all visceral and peritoneal lesions and Hyperthermic Antiblastic Peritoneal Perfusion (HAPP). In three cases we programmed a two stage surgical approach for the massive amount of peritoneal implants. Two times we achieved our aim, while one time, the wide progression of the disease during the two surgical procedures made useless our efforts to have a complete cytoreduction and the following HAPP. This last patient refused systemic chemotherapy between the two surgeries and we think that this should be one of the reasons of the failure.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2001

Older adult multiorgan donors and misdiagnosed tumor.

BACKGROUND: In these last years, the increase in organ donations is mostly due to old patients died of primary vascular cerebral diseases. In this kind of patients some undiagnosed cancers can be present and can be transmitted to the receiver. Aim of this study is to carry out a research in order to identify any undiagnosed cancer which can be present during the period of encephalic death. METHODS: Perspective study: hospitals type II and type III. Polyvalent intensive care. From January 1999 to July 2000 encephalic death has been ascertained in 16 patients. The research of tumor markers has been carried out on these patients. Further diagnostic researches have been carried out on patients who had anomalous values. RESULTS: The organ donations have not been made by eight patients: five for family refusal, one for medical contraindications, two for the presence of undiagnosed tumor (PSA 1100 ng/ml and CEA 129.5 ng/ml) confirmed by prostatic and abdominal US imaging. A patient with CA 19-9 89.5 ng/ml has not been examined, because of the family refusal to donation. A patient with PSA of 135 ng/ml had a negative response from the anal scanner, and so the prosecution of the donation has not been interrupted. A blood sample has been taken and a biopsy of the prostate has been made to confirm the absence of neoplasm. CONCLUSIONS: It is necessary to make a careful examination of the organ donor to check if some cancers are present. Tumor markers cannot be used to make a diagnosis of a cancer, but they can be used as guide for further researches. In spite of all the diagnostic efforts, the objective evaluation of the surgeon is still the most important factor like the biopsy of all the suspected lesions during an operation and the autopsy.

Adult↗
PubMed2000

Decreased systemic polymorphonuclear neutrophil (PMN) rolling without increased PMN adhesion in peritonitis at remote sites.

BACKGROUND: Previous in vitro studies have demonstrated that the host response to intra-abdominal infection produces increased generalized polymorphonuclear neutrophil (PMN) adherence to vascular endothelial cells (ECs), which may lead to subsequent endothelial damage, leaky capillaries, and organ dysfunction. There are scant data to demonstrate this enhanced systemic PMN adherence in vivo or the influence of PMN rolling on PMN endothelial adherence. HYPOTHESIS: Systemic PMN adherence in the animal with sepsis is increased. DESIGN: In vivo murine model of a 2-front infection using intravital microscopy of the cremasteric muscle to quantify PMN-EC adherence in a septic response. SETTING: Basic science laboratory and animal surgical facility. PATIENTS OR OTHER PARTICIPANTS: One hundred CD1 male mice. INTERVENTIONS: Animals underwent cecal ligation and puncture peritonitis, cremasteric muscle Escherichia coli infection, both infections, or neither (controls). Eighteen hours later, the mice underwent exteriorization of the cremasteric muscle under an intravital microscope for measurement of PMN-EC interactions. Blood was then drawn for calculation of circulating PMN counts. MAIN OUTCOME MEASURES: Adherence of PMNs, PMN rolling flux, PMN rolling velocity, and circulating PMN counts. RESULTS: Circulatory mechanics did not differ between the groups. Unlike static in vitro systems, we could not detect an increase in PMN adherence after peritonitis with this dynamic in vivo model. A local (cremasteric) infection was associated with marked PMN adherence. Peritonitis was associated with reduced PMN adherence at a local infection site as well as reduced rolling adhesion and PMN rolling velocity. CONCLUSIONS: The data suggest that intra-abdominal infection does not increase remote PMN adherence, and may actually result in reduction of systemic adherence via modulation of PMN rolling.

Abdominal Muscles↗
PubMed1999

Molecular analysis of hyperoxaluria type 1 in Italian patients reveals eight new mutations in the alanine: glyoxylate aminotransferase gene.

Systematic screening using the SSCP technique followed by sequencing of bands with abnormal mobility derived from the AGXT exons of 15 unrelated Italian patients with primary hyperoxaluria type 1 (PH1) allowed us to characterize both the mutant alleles in each individual. Eight new mutations were identified: C155del, C156ins, G244T, C252T, GAG408ins, G468A, G588A and G1098del. This study demonstrates both the effectiveness of the screening strategy chosen to identify all the mutant alleles and the high degree of allelic heterogeneity in PH1.

Alanine↗
PubMed1997

Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer.

BACKGROUND: Stage Ib and IIa cervical carcinoma can be cured by radical surgery or radiotherapy. These two procedures are equally effective, but differ in associated morbidity and type of complications. In this prospective randomised trial of radiotherapy versus surgery, our aim was to assess the 5-year survival and the rate and pattern of complications and recurrences associated with each treatment. METHODS: Between September, 1986, and December, 1991, 469 women with newly diagnosed stage Ib and IIa cervical carcinoma were referred to our institute. 343 eligible patients were randomised: 172 to surgery and 171 to radical radiotherapy. Adjuvant radiotherapy was delivered after surgery for women with surgical stage pT2b or greater, less than 3 mm of safe cervical stroma, cut-through, or positive nodes. The primary outcome measures were 5-year survival and the rate of complications. The analysis of survival and recurrence was by intention to treat and analysis of complications was by treatment delivered. FINDINGS: 170 patients in the surgery group and 167 in the radiotherapy group were included in the intention-to-treat analysis; scheduled treatment was delivered to 169 and 158 women, respectively, 62 of 114 women with cervical diameters of 4 cm or smaller and 46 of 55 with diameters larger than 4 cm received adjuvant therapy. After a median follow-up of 87 (range 57-120) months, 5-year overall and disease-free survival were identical in the surgery and radiotherapy groups (83% and 74%, respectively, for both groups), 86 women developed recurrent disease: 42 (25%) in the surgery group and 44 (26%) in the radiotherapy group. Significant factors for survival in univariate and multivariate analyses were: cervical diameter, positive lymphangiography, and adeno-carcinomatous histotype. 48 (28%) surgery-group patients had severe morbidity compared with 19 (12%) radiotherapy-group patients (p = 0.0004). INTERPRETATION: There is no treatment of choice for early-stage cervical carcinoma in terms of overall or disease-free survival. The combination of surgery and radiotherapy has the worst morbidity, especially urological complications. The optimum therapy for each patient should take account of clinical factors such as menopausal status, age, medical illness, histological type, and cervical diameter to yield the best cure with minimum complications.

Adult↗
PubMed1997

[A case-control study of multiple sclerosis in Alcoi].

INTRODUCTION: Multiple sclerosis (EM) is a neurological disorder of great epidemiological interest. Considerable variations have been described regarding the initial description of geographical distribution. In the Alcoi health district an epidemiological study showed more cases than would be expected from the latitude. Objective. To care out an analytical study to determine which factors influence this situation. MATERIAL AND METHODS: We carried out a case-control study, pairing one case with four controls from the population, as regards age, sex and place of residence. Only current cases were included, under the control of the only Neurology Unit in the area, and which fulfilled criteria defined by EM. The control group was randomly selected from the census. RESULTS: We analyzed 37 patients and 148 controls. There were no significant differences between the cases and the controls regarding socio-educational level, order of birth within the family, blood group, toxic habits and family history. We found a significantly greater frequency of urinary infections before the age of 15, and of cystitis and pneumonia after reaching the age of 15. Contact with textiles, their finished products and dogs reached significant values. In the patient group there was a significantly higher number of immigrants than in the control group. CONCLUSIONS: The correlation found between certain factors such as contact with textiles, their finished products and dogs should be evaluated in further studies in which the immigration factor is controlled.

Adult↗
PubMed1996

[Introduction of definite molecular weight heparan sulfate in a protocol of prevention of deep venous thrombosis in prosthetic orthopedic surgery].

Use of definite molecular weight heparan sulphate in a protocol for the prevention of deep venous thrombosis in the total joint replacement surgery. The authors propose a working protocol for the prevention of deep venous thrombosis in prosthetic orthopaedic surgery. It requires that integration of pharmacological, anaesthesiological, rheological and physiokinesitherapic measures, it has permitted a very good prevention of thromboembolic disease and it is well-tolerated and safe. The protocol requires: peripheral anaesthesia (sub-arachnoidal block), pre and post-operative pharmacological treatment with heparan-sulphate of a fixed molecular weight, haemodilution with maintenance of the haematocrit at no more than 30%, early physiokinesitherapy associated with the use of elastic stockings graduated tension. The fifty patients treated with this protocol were controlled during the pre-operative and post-operative stage and one month later and no thrombo-embolic complications resulted.

Aged↗
PubMed1995

Generation of a transcription map at the HSD17B locus centromeric to BRCA1 at 17q21.

A detailed transcription map of the 320-kb region containing the HSD17B locus on chromosome 17 was generated. Thirty unique cDNA fragments, retrieved following the hybridization of immobilized YACs to primary pools of cDNAs prepared from RNA of mammary gland, ovary, placenta, and the Caco-2 cell line, were aligned into 10 transcription units by physical mapping and hybridization to RNAs of a series of tissues. The cDNAs were then further characterized by sequencing and used to screen mammary gland cDNA libraries. Fragments corresponding to the broadly expressed gamma-tubulin and Ki antigen genes were identified. A full-length cDNA clone encoding a 117-amino-acid protein homologous to the rat ribosomal protein L34 was isolated. Portions of genes with restricted patterns of expression were also obtained, including the previously characterized HSD17B1. One new gene, for which a full-length cDNA was isolated, was found to have an interesting tissue-specific pattern of expression with abundant mRNA in both the colon and the testis and in the mammary carcinoma cell line BT-474. This contrasted with the barely detectable level observed in several tissues including normal mammary gland. Of the five additional transcription units identified, one showed no similarity, two showed identity to human expressed sequences, and two displayed similarity to genes of animal species by amino acid alignment. These latter cDNA clones include potential homologues of a rat nuclear tyrosine phosphatase and of a factor of Drosophila that is known to be involved in the negative regulation of transcription of segment identity genes.

Amino Acid Sequence↗
PubMed1994

[Continuous infusion of doxorubicin for 10 days as third-line chemotherapy in metastasized breast tumors. Initial observations].

The authors undertook a study to test the feasibility and efficacy of doxorubicin (Dox) administered as continuous infusion (c.i.) in the treatment of advanced breast cancer patients. All patients were previously treated as first line chemiotherapy with bolus-administered Dox; then they received a second line treatment without Dox. Patients were eligible if they had advanced measurable breast cancer, resistant to first and second line chemotherapy regimens, and if previous Dox treatment had been performed more than one year before, and after ECG and cardiac echographic controls were performed. A dose of 4.5 mg/m2/day of Dox was planned for 10 consecutive days in c.i. through a central venous catheter, repeated at 28 day intervals, for a maximum of 10 cycles. Among the 71 patients, 56 received 3 or more treatment courses; 10 patients refused further therapy after the first cycle. Objective responses were achieved in 25 patients (35%), 3 complete and 22 partial remissions. Stabilization was obtained in 11 patients (16%). The median time to progression was 9.3 months. Obviously, haematological toxicity was the major problem; in the 71 patients, 376 courses were administered (mean number of courses per patient: 5.3): grade 4 neutropenia (WHO system) occurred in 2 patients, and grade 3 in 9 patients; while one patient died of gastric haemorrhage. Severe cardiac toxicity occurred in only one patient who died 24 hours after the beginning of therapy, with ECG lateral ischemia. Grade 4 stomatitis was observed in only one patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1994

[2d and 3d line hormonal therapy in postmenopausal metastatic breast tumor. Comparison of medroxyprogesterone acetate and aminoglutethimide in tamoxifen-resistant patients].

In order to evaluate the effectiveness of second and third line hormone therapy for postmenopausal (spontaneous or surgical) women with metastatic tamoxifen-resistant breast cancer, 293 women aged 36 to 91 (mean 63.6) were divided into two groups submitted to a multicenter study of two treatment schedules: a) Aminoglutethimide (AG; 500 mg daily plus hydrocortisone 40 mg daily); b) Medroxyprogesterone (MPA; 1,000 mg daily per os). Of the 293 patients receiving second line hormone therapy, only 161 were available for third line treatment. In phase 1, 153 patients were treated with AG: 36% had objective responses (complete or partial); of 140 patient receiving MPA, 33% had objective responses (p = 0.045, significant). In the AG-treated group, duration of response was 11.3 +/- 8.4 months as against 8.3 +/- 5.6 months in the MPA group (p = 0.07, significant). In phase 2, 87 women previously treated with MPA received AG, and 74 previously AG-treated patients were given MPA. There were no significant differences in the results obtained. In conclusion, there were no significant differences in the results obtained by AG and MPA treatment as far as toxicity and survival was concerned but there was a statistically significant advantage for AG as second and third line management both as to objective responses and mean time until renewed progression of the disease.

Adult↗
PubMed1993

[The treatment of postoperative shivering with nefopam hydrochloride].

After having considered the physiopathological mechanism of shivering, the authors have estimated in a randomised study the effects of the resolution of shivering by nefopam hydrochloride. This drug a dose of 0.20 mg/kg resolved the symptoms in 100% of cases and the placebo hasn't resolved a case so that case it also obtained the same effects. The authors have proved the efficacy of the nefopam hydrochloride in the control of postoperative shivering in the recommended dose.

Adolescent↗