PubMed Health⌕ Search

Biomedical subjects

L Vitale

Publications and source records attributed to L Vitale.

78 records · Page 5Linked to original sources
PubMedDate not supplied

Use of prognostic factors in improving the design and efficiency of clinical trials in childhood leukemia: Children's Cancer Study Group Report.

Prognostic factors are exerting an increasingly apparent and important influence on the results of comparative treatment regimens in childhood leukemia. Since February 1975, 883 previously untreated children with acute lymphocytic leukemia were entered in a protocol designed to evaluate prognostic factors that influence induction rate, remission duration, and survival and to identify subsets of patients with a high risk of early failure. Stratification was based upon the initial wbc count, and standard and more intensive induction and maintenance therapy programs were compared. The combination of older age (> 10 years), high initial wbc counts (greater than or equal to 20 x 10(9)/liter), and low serum IgG is associated with a significantly lower rate of induction of complete remission. The following factors were associated with an unfavorable prognosis with regard to bone marrow relapse and death: wbc count of greater than or equal to 20 x 10(9)/liter; age > 7 years old; CNS disease at diagnosis; L2 lymphoblasts; hemoglobin level greater than or equal to 11 g/dl; decreased concentration of serum immunoglobulin; and M3 marrow on Day 14 of induction. None of the 41 patients in the low-risk prognostic group (3-7 years old with an initial wbc count of < 10 x 10(9)/liter) with L1 blast cells, normal Ig, and M1 marrow on Day 14 has sustained an adverse event. Identification of prognostic factors should permit more efficient and effective design of future protocols by refining the classification of acute lymphocytic leukemia, decreasing the toxic risk to patients with a better prognosis, and improving the relatively poor remission duration and survival for patients with a poor prognosis.

Age Factors↗
PubMedDate not supplied

[The surgical procedure in a case of accidental lesion due to impalement].

The authors describe a case of intraperitoneal anorectal injury. Such injuries now have an improved survival rate as a result undoubtedly of superior resuscitation, early operative management and early use of antibiotics. Civilian life rectal wounds are usually of the penetrating type. Major complications, both of intra and extraperitoneal injuries, are related to infection. The surgical management of these lesions is primarily a proximal diversion of the fecal stream. This is accomplished by a divided--end colostomy. Local wound care must be given for the inevitable infected foreign tract. When sepsis occurs, the surgeon must be prepared to handle it adequately by appropriate incision and drainage.

Accidental Falls↗
PubMedDate not supplied

[Total gastrectomy: a comparison between manual and mechanical sutures].

The authors report their experience of the use of mechanical staplers in total gastrectomy. The advantages of their use can above all be seen in anastomosis, in particular in high-risk areas like esophago-jejunal anastomosis, in which there is a lower incidence of dehiscence and mortality than when manual suturing techniques are used.

Adenocarcinoma↗
PubMedDate not supplied

[Carcinoma of the large intestine following ureterosigmoidostomy in a patient with bladder exstrophy].

The paper reports a case of intestinal occlusion due to adenocarcinoma of the large intestine as a sequel to ureterosigmoidostomy for exstrophy of the bladder which was subsequently converted to ureteroileocutaneostomy. Inadequate follow-up did not allow an early diagnosis to be made. The authors underline the need for annual colonoscopy in all patients suffering from or with previous ureterosigmoidostomy given the high incidence of malignant transformation of the colon.

Adenocarcinoma↗