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Biomedical subjects

N Baldini

Publications and source records attributed to N Baldini.

At least 91 records · Page 5Linked to original sources
PubMed1988

Radio-induced sarcomas in survivors of Ewing's sarcoma.

Of 255 cases of Ewing's sarcoma recorded at the Bone Tumor Center of the Rizzoli Orthopaedic Institute, 78 patients (irradiated and with a follow-up of longer than 3 years) were considered "at risk" for the development of a second radio-induced sarcoma (RIS). Three of the 78 patients developed an RIS in the irradiated field. Theoretical and statistical analyses were carried out considering different modalities of local treatment. Statistically, the only significant factor was related to the irradiation dose. Surgical resection seems to prevent RIS.

Adolescent↗
PubMed1988

Giant-cell tumor of bone with pulmonary metastases. Six case reports and a review of the literature.

Giant-cell tumor of bone rarely metastasizes to the lung. In three of six cases, lesions in lung tissue were histologically benign. In 39 such cases reported in the literature, the treatments were surgical extirpation, chemotherapy, and radiation therapy. Resection was indicated to definitely diagnose the pulmonary lesions as benign giant-cell tumors. Radiation therapy and/or chemotherapy may be beneficial as adjuvant treatment, especially where the lesions are anatomically inaccessible. Some pulmonary lesions spontaneously regress even in the absence of definitive treatment.

Adult↗
PubMed1987

[Therapy of non-metastatic Ewing's sarcoma (pelvis excluded). Results obtained in 48 cases combining local therapy (radiation and/or surgical) and adjuvant chemotherapy with vincristine, adriamycin, dactinomycin and cyclophosphamide].

Combined therapy was used on a consecutive series of 48 patients with extrapelvic Ewing's sarcoma at the Rizzoli Orthopaedic Institute. The adjuvant chemotherapy protocol (VCR, ADM, D-ACT, EDX) was identical in all patients whereas local treatment consisted of amputation, resection and radiation treatment or radiation alone. At a mean follow-up of 58 months (39-78) 30 patients (60%) were free of the disease. This is a significantly higher percentage than that obtained in the same period with adjuvant chemotherapy using only 3 drugs (VCR, ADM, EDX). As far as the type of local treatment is concerned, the percentage of local recurrences and metastases was lower when the primary lesion was treated with surgery or surgery combined with radiotherapy, rather than radiation treatment alone. These suggest that if associated with radiation treatment and chemotherapy, surgery can play an important role that should be considered in the treatment of extrapelvic Ewing's sarcoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Clinical evaluation of 104 hip resection arthroplasties after removal of a total hip prosthesis.

Functional results of resection arthroplasty are currently considered poor. In 104 hip prosthesis removals after either septic or aseptic loosening, pain, walking, joint motility, life style, and patient's opinion were evaluated. A satisfactory result was recorded in 72% of cases. Prognosis is poorer in patients who are young, have septic loosening, and have poor residual mobility. Resection arthroplasty should be considered a salvage procedure in cases of septic loosening and/or bone stock deficiency after a failed total hip arthroplasty.

Adult↗
PubMed1987

Giant-cell tumor of bone.

Of 327 patients who had a giant-cell tumor of bone and were seen at the Istituto Rizzoli, 293 were treated at the Institute, and 280 of these were followed for two to forty-four years. The distribution according to sex and age of the patient and site of the tumor was similar to the distributions in major reports of large series. The tumor usually involved the metaphysis and the epiphysis, but was occasionally limited to the metaphysis, and in only 2 per cent of the patients was it adjacent to an open growth plate. The tumor on occasion invaded the articular space, also involving the ligaments and the synovial membrane. Extension to an adjacent bone through the joint occurred in 5 per cent of the tumors. Our radiographic grading, which is roughly comparable with the staging system of Enneking et al., was Grade I in 4 per cent, II in 74 per cent, and III in 22 per cent of 266 patients before treatment. A pathological fracture was apparent on the first radiograph in 9 per cent of the patients. In the 280 patients with adequate follow-up, 331 surgical procedures were performed. The rate of local recurrence was 27 per cent in the 151 intralesional procedures, 8 per cent in the 122 marginal excisions, and zero in the fifty-eight wide or radical procedures. These results did not correlate with the radiographic grade of the lesion. Of the fifty-one local recurrences that were seen after treatment at our institution, 90 per cent appeared in the first three years after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Giant cell reparative granuloma and other giant cell lesions of the bones of the hands and feet.

The present paper is a clinico-pathologic study of 52 osteolytic lesions containing giant cells, affecting the hands and feet and comprising 11 giant cell reparative granulomas, nine giant cell tumors, six chondroblastomas, and 26 aneurysmal bone cysts. The nature of osteolytic lesions of hands and feet must be carefully established in order to plan appropriate treatment without damaging the surrounding structures. Giant cell reparative granuloma has to be distinguished from other lesions containing giant cells. Clinical and radiologic findings proved of limited diagnostic value; the definitive diagnosis can be established only by histologic examination. Surgical treatment is discussed.

Bone Cysts↗
PubMed1986

Benign fibrous histiocytoma of bone.

The cases of seven patients who had a lytic lesion that was histologically similar to a metaphyseal fibrous defect (non-ossifying fibroma) of bone were studied. The patients all were adults and had pain without a fracture. These features were considered distinctive for the lesion, which has the same histological appearance as benign fibrous histiocytoma of soft tissue. The lesion is a benign tumor with fibroblastic and histiocytic differentiation. This picture may be seen in foci in other lesions of bone (aneurysmal bone cyst, fibrous dysplasia, and giant-cell tumor). Ten cases of giant-cell tumor of bone that had a large component of the same foci were also reviewed. It should be emphasized that these areas are secondary reactive tissue rather than the true neoplastic tissue of benign fibrous histiocytoma.

Adult↗
PubMed1986

Sarcomatous degeneration of giant cell tumours.

Sarcomatous degeneration in giant cell tumours (G.C.T.) usually only occurs in patients of late adult age. Unlike other Centres, we have not up to now observed primary malignant G.C.T. In 327 cases registered at the Tumour Centre of the Rizzoli Institute, there were 10 cases of sarcomatous degeneration. In 8 of these, radiotherapy had been used as the initial treatment of the tumour. The incidence of sarcomatous degeneration when the radiation dose exceeded 4000r was 29%. The prognosis in such cases is very serious, the only feasible treatment being amputation. The possibility of sarcomatous degeneration must be considered before deciding to adopt radiotherapy as the method of primary treatment in giant cell tumours.

Adult↗
PubMed1985

Clinical and radiographic long term results of acetabular fractures associated with dislocations of the hip.

The authors carried out a long term review of 246 cases of fracture dislocation of the hip, based on a new classification of these injuries into six types. The average follow-up was 10 years (minimum 4 years). The review was aimed at ascertaining and comparing the clinical and radiographic results in each group in relation to type of treatment, age, sex, quality of reduction and time to weight-bearing. The survey revealed discrepancies between the clinical and radiographic results that underlined the essential difference between idiopathic osteoarthritis and post-traumatic arthritis. The most important factor in reducing the incidence of ischaemic necrosis was reduction of the dislocation within 24 hours. Arthritis was more dependent on the quality of reduction than on the method of treatment used to achieve it, and was also less frequent when weight-bearing had been delayed for 60 days. The overall results were better in younger subjects.

Acetabulum↗
PubMed1985

Total prosthetic replacement in tabetic arthropathy of the hip joint.

The treatment of tabetic arthropathy of the hip by prosthetic replacement has been recorded in the literature in 5 cases, of which only 4 were followed up. The authors present 4 more cases in which follow-up showed that the operation was definitely contraindicated in this condition. All the cases developed recurrent subluxation and/or loosening of the prosthesis.

Aged↗
PubMed1985

Phenol as an adjuvant in the control of local recurrence of benign neoplasms of bone treated by curettage.

Throughout the present century phenol has been used to "sterilise" the edges of cavities left in bone after the clearance of benign tumours in order to reduce the risk of local recurrence. The results have been analysed of 165 benign bone tumours capable of local recurrence (aneurysmal bone cyst, chondroblastoma, giant cell tumour) treated with and without the use of phenol. The overall recurrence rate was 41% in 98 cases treated by simple curettage and 7% in 27 cases treated by curettage followed by the application of phenol.

Adolescent↗
PubMed1983

Occurrence of different types of contractile cells in some lung fibrosis.

Two different morphologic patterns of pulmonary fibrosis have been identified by means of anti-actin antisera and electron microscopy. The first type, observed in chronic passive congestion and also in radiation-induced fibrosis, is characterized by hyaline alveolar walls, with scarce cells, mostly normal fibroblasts. The second type, on the contrary, shows a high cellularity of the alveolar walls with actin-rich cell proliferation, i.e. contractile interstitial cells in usual interstitial pneumonia and shock lung, myofibroblasts in organizing pneumonia, and smooth muscle cells in honeycomb lungs.

Adult↗