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Biomedical subjects

M Galimberti

Publications and source records attributed to M Galimberti.

At least 109 records · Page 6Linked to original sources

Marrow transplantation for children with acute leukemia: experience of Pesaro.

Thirty children aged 1-15 years with acute lymphoblastic leukemia and acute nonlymphoblastic leukemia were transplanted from HLA-matched donors using two different preparative regimens: 18 patients were prepared with cyclophosphamide and total body irradiation (TBI) while 12 patients received busulphan and cyclophosphamide. Fifteen patients survived 7 to 74 months after transplant. The association of busulphan and cyclophosphamide is a well-tolerated preparation for bone marrow transplant in children with eradicating and immunosuppressive efficacy comparable to that of the well-experienced TBI-cyclophosphamide association.

Actuarial Analysis↗

Evaluation of ventricular function by echocardiography and radionuclide angiography in patients treated with mitoxantrone.

Mitoxantrone, an anthracenedione derivative structurally similar to anthracycline, was tested in 25 Phase II patients with advanced breast cancer, previously treated with different cycles of 5-fluorouracil. Cardiac toxicity was evaluated by means of electrocardiography, echocardiography and radionuclide left-ventricular ejection fraction. Ten patients received a cumulative dose less than 70 mg/m2 (median 33.6, range 28-63) and 15 a dose equal to or more than 70 mg/m2 (median 81, range 70-84). ECG abnormalities in the form of dysrhythmias and ST-T changes were observed in 41% of the patients. Echocardiographic myocardial function parameters recorded in 10 of the 15 patients who received more than 70 mg/m2 demonstrated a trend to deterioration, whereas the nuclear angiographic ejection fraction recorded in all 15 patients who had more than 70 mg/m2 had significantly decreased. No patients developed congestive heart failure but almost one-quarter of them had a fall in myocardial function parameters of more than 15% compared to pretreatment values. These data indicate that mitoxantrone has a significant toxic effect on myocardial cells also at cumulative doses of less than 85 mg/m2 which is generally considered beyond the limit of safety for patients without risk factors.

Adult↗

[Skin diseases and primarily dermatologic cutaneous manifestations of venous disorders. Clinical elements and differential diagnosis].

The paper describes the most common dermatoses having a venous pathogenesis, with particular reference, because of their incidence, to the cutaneous manifestations of varicose syndrome. The pathophysiological basis, clinical picture and diagnostic investigations of dermatoses in venous diseases are discussed and compared with other cutaneous manifestations of non-venous diseases with which they are easily confused. The great importance of a specialised multidisciplinary approach for the correct management of a patient with these dermatological problems is emphasised.

Diagnosis, Differential↗

Evaluation of cardiotoxicity of a new anthracycline derivative: 4'-deoxy-4'-iodo-doxorubicin.

The present study in rats was performed to evaluate the cardiotoxic activity of 4'-deoxy-4'-iodo-doxorubicin (4'-deoxy-4'-I-DXR), a new anthracycline derivative with interesting antineoplastic properties and possible lower cardiotoxicity than doxorubicin (DXR). DXR produced ECG alterations consisting of a progressive and irreversible prolongation of SaT and QaT. In contrast, in 4'-deoxy-4'-I-DXR-treated rats the increase in SaT and QaT duration was significantly lower than that observed in DXR-treated rats and slightly increased over controls. DXR produced significant histologic changes in myocardium consisting of myocyte vacuolization and myofibrillar loss. No significant modifications were observed in mitochondria. In contrast, no significant cardiac lesions were observed in 4'-deoxy-4'-I-DXR-treated rats. These results suggest that this new anthracycline derivative has a significantly lower degree of cardiotoxic activity than DXR.

Animals↗

A comparative trial of posttransplant immunosuppression in patients transplanted for thalassemia. Cyclosporine alone versus cyclosporine, cyclophosphamide, and methotrexate.

This study compares the efficacy of 2 posttransplant immunosuppressive regimens for prevention of graft-versus-host disease (GVHD). Forty-four patients, ages 8-15 years, with homozygous beta thalassemia received marrow allografts from HLA-identical siblings following an ablative regimen of busulfan and cyclophosphamide. Twenty-two patients received cyclosporine (CsA) alone and 22 received cyclosporine, cyclophosphamide, and methotrexate for prophylaxis against GVHD. Two who received CsA alone have died (1 of graft rejection and 1 of acute GVHD) as did 4 patients who received 3 drugs (1 of rejection, 1 of acute GVHD, 1 of infection and cardiac failure before engraftment, and 1 of acute respiratory failure before engraftment). One patient in each group rejected the transplant and survives with thalassemia. The probability of developing acute GVHD was 41% for the CsA group and 15% for the 3-drug group (P = less than 0.05). Patients receiving CsA alone had a probability of event-free survival of 86% compared to 77% in the group receiving 3 drugs (P = 0.40) with a followup of 209-706 days. Although the study showed a decrease in the incidence of GVHD in recipients of the more intensive prophylactic regimen, this study was terminated since it was apparent that even if larger numbers of patients were studied it would be difficult to demonstrate a significant survival advantage with the use of this drug regimen.

Adolescent↗

Relapse after allogeneic bone marrow transplantation for Philadelphia chromosome positive chronic myeloid leukemia: cytogenetic analysis of 24 patients.

One hundred patients with chronic myeloid leukemia (CML) submitted to bone marrow transplantation (BMT) were included in a cooperative cytogenetic study. Relapse (defined on the basis of hematological and cytogenetic findings) occurred in 24 (24%) patients at different intervals after BMT. In 18 of these patients (studied on average 3.3 times between BMT and relapse) no Ph-positive metaphases were detected before relapse. Sixteen (75%) of the patients relapsed with the same chromosomal pattern as that seen before BMT; eight patients, of whom five relapsed in blast crisis, showed additional chromosomal abnormalities resembling those seen in non-transplanted patients. One of these patients relapsed in cells of donor origin. After recognition of relapse, various hematological and cytogenetic patterns were observed. Four patients showed spontaneous reversion to normal (donor-type) chromosomes and hematology. Two other patients were followed for prolonged periods with hypercellular marrows with more than 50% Ph-positive cells but with normal peripheral blood values. The majority of patients proceeded to clinical relapse and required treatment with chemotherapy. We conclude that the isolated finding of a minority of Ph-positive metaphases after BMT should not be classified as relapse; for patients who do relapse, the sequence of cytogenetic and hematological events thereafter is variable.

Adolescent↗

[Evaluation of several parameters of coagulation in liver cirrhosis: disseminated intravascular coagulation or pseudo-disseminated intravascular coagulation?].

Reports in the literature on the difficulty of differential diagnosis between Disseminated Intravascular Coagulation (DIC) Pseudo-DIC and Primary Fibrinolysis (PF) in patients with liver disease, stimulated a study of various coagulation parameters (PT, PTT, Platelets, Fibrinogen, FDP) in 28 cirrhotic patients. The study confirmed reports in the literature on the high incidence of circulating FDP among liver disease patients. The vital role these play in maintaining alterations in haemostasis means that cirrhosis cases must be approached with extreme caution, avoiding any therapeutic or instrumental procedure liable to worsen the already disturbed coagulation pattern in such patients.

Adult↗

Clinical evaluation of the cardiac toxicity of 4'-deoxy-doxorubicin.

4'-deoxy-doxorubicin, a new doxorubicin analog, was tested in 65 phase II patients with advanced malignancies. Cardiac toxicity evaluation was performed by means of electrocardiography (ECG), left ventricular systolic time intervals, echocardiography and radionuclide left ventricular ejection fraction. ECG abnormalities were observed in a lower percentage of patients (23%) compared to that described for doxorubicin and other anthracycline analogs such as 4'-epi-doxorubicin and 4-demethoxy-daunorubicin. Other functional parameters serially measured to evaluate chronic cardiotoxicity in 23 patients, who received more than 200 mg/m2 were not significantly different from mean pretreatment values. No patient developed congestive heart failure but some of them exhibited a fall of left ventricular function parameters more than 15% from pretreatment values. These data suggest that this new analogue is probably less cardiotoxic than the parent compound doxorubicin but not completely devoid of cardiotoxicity.

Adolescent↗

[Reactions caused by Hymenoptera: a first aid problem].

The incidence of reactions to insect bites both local (erythema, pemphigus, oedema, itching) and systemic (urticaria, angioedema, anaphylactic shock) in Borgomanero (NO) National Health Clinic 54 was assessed. The high incidence of medical treatments for this pathology encountered reflects the fact that in the summer and in a rural area a great many people are exposed to this type of emergency. The importance of careful diagnosis (anamnesis, skin allergy tests, RAST is emphasised as a means of identifying cases at allergic risk and providing the appropriate immunotherapy.

Animals↗

[Contact sensitization in eczema of the hands].

A personal series of patients with eczema on the hands arising in non-occupational conditions was examined (students, housewives, clerical workers, teachers, farm labourers). The data obtained indicate the presence of allergic sensitisation in 70% of the cases and especially among females (3 : 1). The most frequently encountered allergens were difenylguanadine (used in rubber manufacture) and nickel. It is therefore suggested that patch tests should be performed immediately on these patients so that contact with allergen can be prevented in addition to the usual topical treatment.

Adolescent↗