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Biomedical subjects

L Merlini

Publications and source records attributed to L Merlini.

187 records · Page 11Linked to original sources
PubMedDate not supplied

Methotrexate, mitoxantrone, 5-fluorouracil and leucovorin in metastatic breast cancer patients.

We have evaluated the efficacy and toxicity of a chemotherapy consisting of methotrexate, mitoxantrone, 5-Fluorouracil and leucovorin in 21 advanced breast cancer patients. Among 20 evaluable patients, objective response was obtained in 6 patients (30%) with two complete responses, stable disease in 4 patients (20%), while 10 patients (50%) progressed. Median progression-free survival and survival were 10 and 15 months, respectively. The most frequently observed side-effects were myelosuppression and emesis; one patient, who had previously received doxorubicin at the maximum dose-limiting cardiac toxicity, died of congestive heart failure after the third cycle. This treatment is moderately effective for advanced breast cancer patients.

Adult↗
PubMedDate not supplied

[Computed tomography in the diagnosis of pulmonary barotrauma associated with the adult respiratory distress syndrome].

In the patients suffering from adult respiratory distress syndrome (ARDS), pulmonary barotrauma is a frequent and fearful complication, whose timely and accurate diagnosis is therefore needed. To this purpose, bedside chest films often exhibit some diagnostic drawbacks. Computed tomography (CT) of the chest is rarely used because of the problems concerning the transfer and the control of these critically ill patients outside the Intensive Care Unit. The chest CT findings of 84 ARDS patients were retrospectively reviewed, investigating: a) the presence of barotrauma (pulmonary bullae, pneumothorax, pneumomediastinum, subcutaneous emphysema); b) the positioning of thoracostomy tubes; c) the chest films performed on the same day as CT. CT showed the presence of barotrauma in 41 patients. Pulmonary bullae were seen in 26 cases (31%), pneumothorax (mainly in anteromedial location) in 27 cases (32%) and pneumomediastinum in 11 cases (13%). In 22 patients with thoracostomy tubes CT demonstrated the exact site of the drainages: in 7 cases only the tubes were correctly positioned, or were working properly. The presence of pulmonary bullae (regarded as the evidence of interstitial pulmonary emphysema) proved to be associated with a higher mortality rate than that of the entire sample (58% vs 38%); in 30 of 41 patients with barotrauma (73%) CT proved to be superior to chest films, especially to demonstrate pulmonary bullae (26 cases detected by CT vs 7 cases diagnosed by chest films). In 14 of 41 patients with barotrauma the information yielded by CT directed the choice of treatment: thoracostomy tubes were positioned in the cases of pneumothorax undetected by chest films and in the cases of only partially drained multilocular pneumothorax, or replaced in the event of tube mispositioning. In conclusions, in ARDS patients the use of chest CT is recommended in selected cases only, when complications (especially barotrauma) are suspected and unrevealed by bedside chest films.

Adult↗
PubMedDate not supplied

Lesions of the sciatic nerve in fractures of the acetabulum.

Between 1982 and 1992 a total of 211 fractures of the acetabulum were operated. There was lesion of the sciatic nerve in 21 cases, the pathogenesis and evolution of which were studied. Clinical follow-up was obtained at least 2 years after occurrence of neurological deficit and supported in 13 cases by electromyography. Based on an analysis of the literature and of these series it is observed how spontaneous recovery of paralysis is not rare, even if it requires a long period of time. The presence of various levels of lesion, which are not easily diagnosed, and which are not easily attacked surgically, calls for a prudent attitude with regard to neurolysis.

Acetabulum↗