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Biomedical subjects

P Picozzi

Publications and source records attributed to P Picozzi.

At least 19 recordsLinked to original sources
PubMed2006

MATILDE regimen followed by radiotherapy is an active strategy against primary CNS lymphomas.

The authors assessed MATILDE chemotherapy followed by response-tailored radiation therapy in 41 patients aged 70 years or younger with primary CNS lymphoma in a Phase II trial. With response rates of 76% after MATILDE and 83% after chemotherapy with or without radiation therapy, this was an active strategy, particularly in low- to intermediate-risk patients (International Extranodal Lymphoma Study Group [IELSG] score). Myelosuppression was the dose-limiting toxicity, with 9.5% of lethal complications. After a median follow-up of 49 months, a plateau in the survival curve (5-year overall survival: 41 +/- 7%) was obtained.

Adolescent↗
PubMed2003

Genomic organization and transcription of the human retinol dehydrogenase 10 (RDH10) gene.

A cDNA clone up-regulated in hydraulic lung edema in rabbit showed high similarity with human RDH10 mRNA, which encodes a protein involved in retinoic acid metabolism. We defined the organization of the human gene, which includes a unique transcriptional start site, a coding region with six translated exons and a 3' untranslated region containing at least two used polyadenylation sites. The two poly(A) signals are responsible for the production of the 3 and 4 kb RDH10 mRNA isoforms detected in several human tissues and cell lines.

3' Untranslated Regions↗
PubMed2000

Palpatory method used to identify the recurrent laryngeal nerve during thyroidectomy.

The major complication of thyroid surgery, occurring in 1% to 6% of cases, is injury to the recurrent laryngeal nerve (RLN). A simple method to identify the RLN during thyroid surgery is described by the authors. It consists in palpation of the nerve caudally to the inferior pole of the thyroid, after the nerve has been made taut by the upward and medial traction of the thyroid gland. This method was used on 47 human cadavers and 45 patients with benign thyroid diseases. It made it possible to identify the RLN in all of the cadavers and 52 of the 55 identifications during 45 thyroidectomies (in 10 total thyroidectomies the identification was bilateral). Laryngeal motility was normal in all patients at postoperative laryngoscopy. Using the palpation before dissection in the region of the inferior thyroid artery, the traditional viewing method became easier and safer, reducing the risk of injury where it is most likely to occur to the nerve.

Cadaver↗
PubMed1998

[Indications for steroid and tirilazad treatment in patients with subarachnoid hemorrhage].

Tirilazad mesylate, a nonglucocorticoid 21-aminosteroid, has been used in two randomized, double-blind, vehicle-controlled trials in Europe, Australia, New Zealand, and in North America in patients with aneurysmal subarachnoid hemorrhage. The first trial has been concluded, enrolled 1023 patients, and demonstrated a dramatic reduction in mortality from 27% to 3% (p = 0.01) in males receiving 6 mg/kg/day tirilazad for 10 days, when compared to vehicle-treated patients. There was also a less incidence of symptomatic vasospasm, and the frequency of hypertensive-hypervolemic-hemodilution therapy was significantly reduced. The reduction in mortality rate was remarkable, however the benefits of treatment with tirilazad were predominantly shown in men rather than in women. This clinical trial suggest that tirilazad mesylate, at a dosage of 6 mg/kg/day, improves overall outcome in aneurysmal subarachnoid hemorrhage patients. Further data from the North America trial and the trial in women receiving higher doses of tirilazad are still pending.

Anti-Inflammatory Agents↗
PubMed1998

Physiopathological criteria of vasospasm treatment.

Cerebral vasospasm following aneurysmal subarachnoid hemorrhage is one of the most important causes of cerebral ischemia, and is the leading cause of death and disability after aneurysmal rupture. The optimal treatment of vasospasm awaits development of agents for blocking or inactivating spasmogenic substances, or blocking arterial smooth muscle contraction. Rheological and/or hemodynamic manipulation using triple-H (hypertensive-hypervolemic-hemodilution) therapy to prevent or reverse ischemic consequences are relatively effective, but complicated and hazardous, and should be viewed principally as interim measures awaiting development of more specific therapies for arterial narrowing.

Blood Volume↗
PubMed1998

Mild hypothermia.

Recent evidence indicates that the relationship between "brain protection" and the degree of hypothermia is not linear, and even mild reduction of body temperature (i.e. 2-5 degrees C) may provide protection against cerebral ischemia. The protective effects of mild hypothermia have been demonstrated in various animal models of cerebral ischemia, and are encouraging in human studies. At the present time, although there is no randomized clinical trial assessing the benefits of mild hypothermia for intracranial aneurysm clipping, some neurosurgical centers are routinely instituting mild hypothermia before vascular occlusion.

Humans↗
PubMed1992

[VIPoma: surgical treatment].

This paper reports a case of pancreatic VIPoma with widespread hepatic metastasis which was treated for approximately 2 years with a synthetic somatostatin analog (SMS 201/995). The treatment of choice in cases in which the tumour was fully removable is surgical resection. This occurred rarely since approximately 80% of VIPomas are malignant and are operated late when local infiltration is already widespread; in addition, 50% of cases are already metastasised at diagnosis. In this case, due to the infiltration of the superior mesenteric artery by the primary tumour it was necessary to carry out a left pancreasectomy which included two-thirds of the neoplastic mass. This was justified by slow tumour growth and also facilitated control of diarrhea and ensured a greater efficacy of possible postoperative chemotherapy. The use of synthetic somatostatin analog (SMS 201/995) enabled diarrhea to be satisfactorily controlled and is therefore specifically indicated for this type of tumour. NSE serum assay (neuron specific enolase) allowed the evolution of disease to be monitored during follow-up.

Female↗
PubMed1990

[What happened to Zollinger-Ellison syndrome?].

Three Zollinger-Ellison syndrome patients were treated during the period January 1977 to June 1978. The first patient is in good health 11 years 3 months after a total gastrectomy as is the second patient, 11 year after the enucleation of a cephalo-pancreatic gastrinoma. However the third patient died from malignancy 5 years after a total gastrectomy and enucleation of a cephalo-pancreatic gastrinoma followed by therapeutic cycles with streptozotocin and 5-fluorouracil. The decline in the Zollinger-Ellison syndrome over the last ten years is examined and the type of surgical treatment is discussed. Total gastrectomy once advocated as the preferred treatment, is now reappraised because of the effectiveness of medical therapy in controlling ulcers and because of the frequent malignancy of pancreatic gastrinomas.

Adult↗
PubMed1989

[Traumatic cervical myelopathies. Effect of the operative timing and systemic complications on the functional outcome].

Results concerning 42 (38 males-2 females) cervical vertebro-medullary traumas are described in which early surgery was undertaken. 24.3% were operated within 24 hrs from trauma; 45% between 24 hrs and 7 days; 26% more than 7 days after: 69.3% during first week. Six patients died (5 of grade 1 in accordance with Sunnibrook; 1 of grade 2) within 30 days after trauma (5 during first week after surgery). These patients had more frequent systemic complications (56% respiratory and cardio-vascular insufficiency). Total mortality during one year was 22.7%. The neurological and rehabilitation observations support the opinion that early operated patients limitedly improved.

Adult↗
PubMed1989

[Somatosensory evoked potentials in the evaluation and follow-up of patients with cervical vertebral and spinal cord injuries].

Somatosensory evoked potentials have been serially recorded in 21 patients with cervical spinal cord injury. Each patient received the SEP test and a full neurological examination within 1 day after admission, after surgery, and 3-6 weeks following admission. Further SEP test and clinical evaluation were carried out 3-6 months after injury. Neurological status was graded according to the Sunnybrook Scale. In all patients we evaluated latency and amplitude of SEPs obtained from both median and tibial nerve stimulation. Immediately following injury SEPs were absent in 6 patients, abnormal in 10, and normal in 5 patients. No surgery was carried out in patients with normal SEPs where myelography and CT scan could not demonstrate surgical lesions. Four patients had some distal motor improvement but SEPs still absent, one had traceable SEPs following surgery but no motor improvement. Surgery was performed in all 10 patients with abnormal SEPs: 7 patients improved following surgery. In two patients SEPs showed an early postoperative recovery with subsequent late clinical improvement. The SEP technique is well suited to the non invasive study of spinal cord condition and serial recording in patients with spinal cord injury. Although SEPs are of limited clinical value when absent immediately following trauma, the presence of well preserved median and tibial SEP in the postinjury period indicates the best prognosis for motor and sensory functions.

Adolescent↗
PubMed1988

Quantitative assessment of blood-brain barrier permeability in multiple sclerosis using 68-Ga-EDTA and positron emission tomography.

Fifteen patients with definite multiple sclerosis were examined with high volume delayed (HVD) CT scan and positron emission tomography (PET) using 68-Ga-EDTA as a tracer. The passage of 68-Ga-EDTA across the blood-brain barrier (BBB) was measured by using multiple graphical analysis. This method permits the simultaneous calculation of a blood to brain influx constant Ki (ml/g-1 min-1) and of the plasma volume Vp (ml/g-1). Focal areas of abnormal CT enhancement and pathological accumulation of 68-Ga-EDTA were visualised in four patients who were all examined during a clinical exacerbation of the disease. The mean Ki value measured in these areas was 12.5, SD 3.4 indicating a moderate but significant increase of BBB permeability compared with the value found in normal tissue (3.2, SD 0.9). No parallel increase in Vp values was found in these pathological areas. Quantitative data obtained with PET seems to provide further insight into the study of BBB function in multiple sclerosis.

Adolescent↗