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Biomedical subjects

M Fiorentino

Publications and source records attributed to M Fiorentino.

100 records · Page 6Linked to original sources

[Treatment with 32P of carcinoma of the prostate (author's transl)].

Twenty-eight patients affected with disseminated prostate cancer, which proved hormone resistant (after castration and oestrogen administration), have undergone combined treatment with Testosterone (for 13 days) and 32P (for the last 7 days of the Testosterone treatment). During the initial fase of the treatment (Testosterone only), 14 patients experienced pain exacerbation and/or fever and one experienced immediate improvement. The exacerbation quickly disappeared following 32P administration, and 26 of the patients had distinct improvement at some time during or after treatment, with a mean remission duration of 3 months and mean survival rate of 7 months. No lytic or soft part deposit showed improvement; improvement was noticeable only in the mixed type or osteo-sclerotic metastases. This observation suggests that the androgen stimulates uptake of the isotope not inside the tumor cells but in the bone matrix around the tumoral deposit. The patient who showed very early improvement had a subsequent relapse on oestrogens, but later responded to the androgen alone.

Humans↗

Tamoxifen in disseminated breast cancer.

86 postmenopausal women with disseminated breast cancer have been treated orally with 30 mg of Tamoxifen per day (ICI 46474, Nolvadex) for periods of 2 months or more. The overall responders were 28/86 (32.5%) with a median remission duration of 9 months. In 30 patients already shown to be resistant to cytotoxic chemotherapy. Tamoxifen was used as first hormonal agent; the remission rate in this group was 12/30 (40%), while it was 28.5% (16/56) in the others who had already received different hormonal treatments. In 6 early menopausal cases, the treatment had to be stopped for a dangerous "worsening syndrome". Other side effects were trivial. In 28/35 cases (80%), we have found the reappearance of a pattern of estrogenic activity in vaginal smears during treatment. Hence a "simil-estrogen", more than an "anti-estrogen" mechanism of action is postulated and a selection of patients for treatment in the "mid postmenopausal age" is recommended.

Breast Neoplasms↗

The value and present indications of staging laparotomy in Hodgkin's disease.

From December 1971 to December 1976 224 patients with Hodgkin's disease underwent diagnostic laparotomy and splenectomy under a multidisciplinary protocol of treatment. In 149/224 (66.5%) the clinical stage of the disease was confirmed, whereas in 75/224 (33.5%) it was modified after surgery. In 7.6% of the patients (17/224) there were postoperative complications. One patient died of myocardial infarction. The rate of complications in the last 100 cases was 5%. Preoperative patient selection, excluding those definitely in stage IV, is of relevance, and it can be done by iliac crest biopsy and laparoscopy. Although a better exploitation of some diagnostic procedures (lymphangiography, laparoscopy) and the expanding use of chemotherapy may reduce in the future the need for staging laparotomy and splenectomy, diagnostic laparotomy is still indicated for the selection and preparation of patients for radiation therapy in stages I, II and III.

Adolescent↗

[Transplant glomerulopathy. Anatomohistopathologic and ultrastructural aspects].

14 cases of transplant glomerulopathy have been observed in 254 specimen taken from 152 renal allografted patients. Lesions have been studied at light, immunofluorescence and ultrastructural level. Following morphological parameters have been evaluated by semiquantitative method: focal mesangial sclerosis, mesangial matrix, mesangial cellularity, glomerular basement membrane thickening, double contours and crescents. Intermediate and advanced stages prevailed with the evidence of capillary aneurysms in 2 out 14 cases. Electron microscopy showed thickening of the glomerular basement membrane with finely lamellar and electron lucent thickening of the lamina rara interna. Transplant glomerulopathy lesions need differential diagnosis with thrombotic microangiopathy and can be considered equivalent of chronic vascular rejection.

Adult↗

[Bone marrow biopsy in HIV-positive patients with thrombocytopenia. Light and electron microscopy].

Isolated thrombocytopenia (platelets less than 100,000 mmc) may be the first clinical symptom in HIV positive patients or occur in all the evolutive phases up to overt AIDS. In this paper bone marrow lesions are evaluated at light and electron microscopy in 32 HIV positive patients with isolated thrombocytopenia (group II and III CDC 1986). At light microscopy an increase in megakaryocytes with small dysplastic changes, plasmacytosis and hypereosinophilia were the bone marrow lesions detected. Electron microscoy revealed megakaryocytes with focal nuclear alterations (hypolobation and dilatation of the perinuclear cisternae) and abnormalities in the maturation of platelets associated with cytoplasmic micro-macrovacuolation, absence of viral particles or of virus correlated structures. About 9% of HIV positive patients presented with isolated thrombocytopenia as a first clinical symptom: thrombocytopenia is not believed to have unfavourable prognostic significance in the evolution to overt AIDS.

Biopsy↗

Adjuvant FAM2 in resectable gastric cancer.

In spite of the improvements in surgical techniques and intensive care, no important benefit in the prognosis of patients with gastric carcinoma has been attained in the last twenty years. Different adjuvant treatment protocols have been proposed in an attempt to improve upon the results obtained with surgery only. In western countries, the FAM chemotherapeutic regimen is one on the most widely used for the treatment of advanced gastric carcinoma. In 1982 the G.I. GROUP of the EORTC proposed a modification (FAM2) to the original FAM as an adjuvant treatment in a controlled clinical study for gastric carcinoma. It is still too early to determine any therapeutic advantages of FAM2 in this protocol. Although the FAM2 regimen is fairly well tolerated, there is some toxicity which, however, seems to be slightly higher than in the regular FAM. It remains to be seen if this is a reasonable price to pay for still unknown therapeutic advantages. In view of the scarcity of available data in this field and the conflicting results which have emerged so far, the results of our study are awaited with great interest.

Adenocarcinoma↗