PubMed Health⌕ Search

Biomedical subjects

R Ponchietti

Publications and source records attributed to R Ponchietti.

At least 19 recordsLinked to original sources
PubMed2005

Weekly paclitaxel and epirubicin in the treatment of symptomatic hormone-refractory advanced prostate carcinoma: report of a phase II trial.

The efficacy of weekly paclitaxel in androgen-independent prostate cancer and its addictive cytotoxicity with anthracycline derivatives led us to determine the safety and efficacy of a weekly schedule of paclitaxel and epirubicin. Between October 2000 and November 2002, 32 patients were enrolled in this study. Patients characteristics included a median age of 72 years (range 68-77), adequate hepatic, cardiac, renal and bone marrow functions, ECOG performance status of 1-2, and no prior chemotherapy. All patients had received hormonal manipulation and seven patients (22%) had received prior palliative radiation therapy. The regimen consisted of paclitaxel 70 mg/m2 i.v. infusion for 2 h and epirubicin 30 mg/m2 in bolus every week. Treatment was continued for 3 months or until disease progression or unacceptable toxicity were observed. During the study, prostate-specific antigen (PSA) was monitored and response was defined as a 50% reduction in PSA levels, to be confirmed 4 weeks later. Thirty-one patients were evaluable for toxicity and 21 for objective response. Seventeen patients (57%) had a decline above 50% in PSA level that lasted more than 4 weeks with a median time to PSA progression and a median duration of PSA response of approximately 5.5 months. Ten of the 21 patients with measurable disease (47%) had a confirmed objective response (one complete response and 20 partial responses). Thirteen of 25 symptomatic patients (56 %) had improvement in pain. The median time to disease progression was 7.6 months and the median survival was 12.9. The most prominent grade 3 toxicities were reversible myelosuppression and fatigue. Nausea, vomiting, diarrhea and peripheral edema were minimal. No evidence of cardiac toxicity was recorded. Alopecia was frequent, but reversible, in all patients. We conclude that despite the small sample size, this study demonstrates that the combination of weekly paclitaxel and epirubicin is a well-tolerated regimen for androgen-independent prostate cancer. The results imply that a combination of these agents in a weekly schedule may have clinical potential in prostate cancer treatment.

Aged↗
PubMed2004

Clinical characteristics and overall survival in genitourinary sarcomas treated with curative intent: a multicenter study.

OBJECTIVES: Adult soft tissue sarcomas in general, and those arising from the urological organs in particular, are a group of rare tumours with a generally poor prognosis, only a few studies are available. We report our experience with this type of tumours in a multicenter study carried out in a single region of Central Italy (Tuscany). METHODS: Pre-treatment and follow-up data were obtained from 22 adult patients, all residing in Tuscany, treated consecutively between 1984 and 2002 for primary or locally recurrent genito-urinary sarcomas in 8 urology departments in the area. All cases were classified according to the French Federation of Cancer Center System Grading Scheme for Adult Sarcomas (FFCC) and Broders System. The crude survival probability was estimated by using the Kaplan-Meier method and differences between patient sub-groups were assessed by the log rank test. RESULTS: The study series included 18 males and 4 females. The mean age at diagnosis was 61+/-21.5 years (range: 15.3-89.1). The most common site was paratesticular (n=9, 40.9%), followed by kidney (n=8, 36.4%), prostate (n=3, 13.6%) and penis and bladder (1 case each, 4.6%). 15 cases (68.2%) were classified as FFCC III, and 16 (72.7%) as Broders IV. The most common histological type was leiomyosarcoma (8 cases, 36.7%), followed by liposarcoma (6, 27.3%), rhabdomyosarcoma (3, 13.6%) and other histological types (5, 22.7%). At the last follow-up (mean: 3.66+/-3.25 years; range 0.15-10.0), 11 of the 22 patients (50%) were still alive. The overall survival rate at 1, 3 and 5 years was 85.9%, 62.0% and 48.8%, respectively. There were no significant differences in survival according to sex, age or histological type. When we compared paratesticular vs. kidney and prostate cancer cases, a significant difference in survival emerged (p=0.02). According to size and grade of the tumour we also found a significant difference in survival (p=0.0006 and p=0.01, respectively). CONCLUSIONS: In our representative series, 3 tumor parameters (site, size and grade) appeared to represent the most important prognostic factors in adult genitourinary sarcomas.

Adult↗
PubMed2003

Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time.

Sildenafil is one of two oral drugs approved for first-line treatment of erectile dysfunction (ED). Anecdotally, some young healthy men who wish to enhance their sexual performance are requesting or abusing sildenafil. In this randomized double-blind, placebo-controlled clinical study, we investigated the effect of sildenafil in young men without ED. A total of 60 young healthy men age 20-40 y with no reported ED were enrolled for this single-dose home-use study. Subjects had used no medication in the 6 months prior to the study. All had been engaged in a stable relationship for at least 3 months. After completing the IIEF-5 questionnaire, patients were randomized in a double-blind fashion to receive either one 25 mg tablet of sildenafil (group 1) taken prior to intercourse, or an identical placebo tablet (group 2). All subjects completed a questionnaire relating to their erectile quality. There were no differences between the two groups in the reported improvement of erection quality, 12/30 sildenafil vs 10/30 placebo (Fisher's test, P=0.79). Sildenafil caused a significant reduction of the postejaculatory refractory time (12/30 vs 4/30) (chi(2) test, P=0.04). Sildenafil does not improve erections in young healthy men. Sildenafil should not be given to young healthy men to improve their erections and patients should be advised against recreational abuse of the drug. In this limited single-dose home study, sildenafil appears to reduce the postorgasmic refractory time. Although controlled studies are needed to evaluate the efficacy of erection-enhancing drugs in premature ejaculation, it is possible that sildenafil might be useful for this indication.

Adult↗
PubMed2002

Phase II trial of weekly intravenous gemcitabine administration with interferon and interleukin-2 immunotherapy for metastatic renal cell cancer.

PURPOSE: Since metastatic renal cell carcinoma has a poor prognosis and treatment strategies, including hormone therapy, chemotherapy and immunotherapy, have little impact on the quality of life and global survival statistics, new interest has recently focused on the combination of immuno-chemotherapy using pyrimidine analogues, such as gemcitabine. MATERIALS AND METHODS: In a phase II study 16 patients with metastatic renal cell carcinoma were treated with 1,000 mg./m. gemcitabine intravenously on days 1, 8, 15 and 28 for 6 months, 3 MU (1 MU = 1 x 10(6) IU) interferon (IFN)-alpha intramuscularly 3 times a week and 4.5 million IU interleukin (IL)-2 subcutaneously daily for 5 days a week for 2 consecutive weeks every month for 6 months. Responding and nonprogressing cases were maintained on immunotherapy consisting of IFN-alpha and IL-2 for further 6 months. RESULTS: In 15 evaluable patients overall response rate (1 complete response plus 3 partial response) was 28% while stable disease was achieved in 7 (47%). Median survival duration was 20 months (range, 9 to 26+) and median time to tumor progression was 14 months (6 to 26+). The complete response lasted 24+ months and partial response lasted 16 months. The regimen was well tolerated with only 1 case of neutropenia (WHO grade 3), while anorexia, fatigue and flu-like symptoms were the most common toxicity problems but were never greater than grade 2. CONCLUSIONS: Despite the small sample size, this study demonstrates that gemcitabine combined with standard doses of IFN-alpha and low doses of IL-2 is effective treatment for metastatic renal cell carcinoma. This biotherapy was well tolerated and resulted in an optimum objective response and relatively long-term survival.

Aged↗
PubMed2002

Penile length is normal in most men seeking penile lengthening procedures.

Concerns over penile size and a desire for a longer penis are common in the male population. The number of male patients seeking an andrological consultation for the problem of 'short penis' is increasing. We looked at the numbers of patients presenting to a University andrology clinic over a 2-y period and correlated their perceived penis size with the accepted norms. Sixty-seven patients were evaluated with a median age of 27 (range 16-55) complaining of 'short penis' and requesting surgical correction. Clinical history, including the IIEF-5 questionnaire and an accurate physical examination were obtained. Data concerning measures of penile length and circumference were recorded in both the flaccid and fully stretched states and compared to the normal reference range as previously described in the nomogram we recently published (Eur Urol 2001; 39: 183-186.). All patients were also asked to estimate the length of a normal sized penis.Fourty-four (65.7%) complained of a short penis only while flaccid, 22 patients (32.8%%) while both flaccid and erect, and only one patient (1.5%) was worried only by the erect length of the penis. Fifteen (22.4%) also complained about their penile circumference. Fifty-seven (85%) patients thought a 'normal' penile length should range from 10 to 17 cm (median value of 12 cm). Ten patients (15%) were not able to estimate 'normal' penile size. No patient was found to have a penile length under the 2.5 percentile according to our nomogram. Forty-two (62.7%) subjects recalled the problem starting in childhood, when they felt that their penis was smaller than their friends'. In 25 patients (37.3%) the problem started in the teenage years after seeing erotic images. Our data show that most men who seek penile lengthening surgery overestimate 'normal' penile length. In our series, none of the patients could be classified as having a severely short penis according to our nomogram and none had any anatomical penile abnormality. Most found the use of a nomgram to show them how they compared with other men helpful. We suggest that documentation of such a demonstration should be made for any man seeking an opinion on penile lengthening surgery.

Adolescent↗
PubMed2001

Penile length and circumference: a study on 3,300 young Italian males.

OBJECTIVE: The knowledge of normal variations in the size of male external genitalia is of considerable interest to several disciplines. We carried out an extensive study in young Italian males to provide estimates of normal variations of penile dimensions. METHODS: The penile length in flaccid and stretched states and the penile circumference were measured in a random group of 3,300 young men aged 17-19 years and free from endocrine disorders and from congenital or acquired abnormalities of the penis. In a random sample of 325 subjects of the same set of people, penile length and circumference were also correlated with weight and height. Statistical analysis was performed with the Sperman test, because our data were not normally distributed as tested by the Kolmogorov-Smirnov test (p < 0.01). RESULTS: The median values of penile dimensions recorded in the present study are flaccid length 9.0 cm, flaccid circumference, at the middle of the shaft, 10.0 cm, and stretched length 12.5 cm. We also observed that the penile dimensions are highly correlated with height and weight. CONCLUSIONS: Since penile length and circumference correlate with anthropometric parameters such as weight and height, we suggest to consider themselves as two bodily measures which display a wide extent of normal variability along the general population.

Adolescent↗
PubMed2001

The role of lomefloxacin in the treatment of chronic prostatitis.

The choice of antimicrobial agents for treatment of prostatitis should be based on two factors: in vitro sensitivity of isolated pathogens and potential intraprostatic penetration of the molecule. Unfortunately, only a few antibiotic agents penetrate prostatic fluid which is the primary site of infection. Lomefloxacin, a once-daily difluoroquinolone, could play a central role in the therapy of prostatitis because it has sufficient liposolubility, low ionization (pKa), low protein binding, small molecular size, long serum elimination half-life and it can pass from interstital fluid across prostatic cells into the lumen. This study was carried out on 12 patients (mean age 65 years) with normal hepatic and renal function, divided into two groups of 6 subjects each. Lomefloxacin was administered for perioperative antisepsis at the dose of 400 mg orally once a day for 4 days. Serum and tissue were sampled in the two groups of patients 4 h (Group A) and 8 h (Group B) respectively after the last drug administration. Tissue penetration was higher than serum, with a T/S >2 in the prostatic capsule and seminal blister, and a T/S >1.6 in the adenomatous tissue, in both groups of patients. In addition, the prostatic tissue concentrations exceeded the MIC for the main pathogens usually involved in urogenital infections. Therefore, because of its pharmacokineitic and pharmacodynamic characteristics, lomefloxacin is proposed as an efficacious therapeutic option, even for the treatment of chronic prostatitis.

Aged↗
PubMed2000

[Andrologic pathology discovered druing conscription screening: how many young men were unaware?].

BACKGROUND: In Italy the visit during conscription is a valid instrument for epidemiologic research. The aim of this study was to evaluate the incidence of andrologic diseases in a population of 18 years old young Italian men and to estimate in how many of them it was a first diagnosis. METHODS: This randomized study was conducted during 1998 at the Military District of Florence where an andrological visit was performed on 11,649 young men living in Tuscany. An evaluation of external genitals and secondary sexual characters was made. All the visits were performed by the same doctor. They were requested to specificity if they were familiar with the professional figure of the andrologist. RESULTS: Some andrological disorders were found in 3892 (33.4%) of them and in 3469 (89.2%) it was the first diagnosis. Only 3.7% knew the role of the andrologist and 70% didn't know where to apply for their problems. CONCLUSIONS: The results of this study showed a poor familiarity with the figure of the andrologist even though about 1/3 of them should be treated for an andrologic disease which is often undiagnosed. It is personal opinion that these results should make us to think about the consequences that the abolition of male conscription may have given that, for many young Italians, the medical check-up for military service is the first, and often the last, occasion for a control of the genital system.

Adolescent↗
PubMed1999

Estimation of prostate cancer volume by endorectal coil magnetic resonance imaging vs. pathologic volume.

OBJECTIVE: Since tumor volume is recognized as an important predictor of clinical stage and disease outcome of prostate cancer, accurate preoperative estimation of tumor volume can play an important role in planning the appropriate treatment and establishing a patient's prognosis. We performed this study to evaluate the accuracy of the endorectal coil magnetic resonance (MR) technique for reliable prediction of tumor volume in patients with prostatic cancer. MATERIAL AND METHODS: Endorectal coil MR imaging was performed in 57 consecutive men who were suspected to have prostate cancer. Subsequent ultrasound-guided transrectal biopsy revealed prostate cancer in 44 cases. The pathological volume of the surgical specimens of 25 selected patients who underwent radical prostatectomy was retrospectively compared to the volume estimated by endorectal coil MR studies, and the Pearson correlation coefficient was calculated. RESULTS: In 15 patients the estimated size of the tumor was within 15% of the true tumor volume; in the remaining 10 cases MR imaging tended to underestimate large tumors and overestimate small ones. A significant correlation between the volumes as determined with MR imaging and measurements of surgical specimens was observed (r 0.94; slope 0.82). To our knowledge, this is the best correlation found between pathological volume and tumor volume as evaluated by any other imaging modality. CONCLUSIONS: Endorectal coil MR imaging is a powerful means of evaluating the prostate gland; however, further improvements in imaging and/or volume calculation are required to provide a more accurate preoperative assessment of prostate cancer volume.

Aged↗
PubMed1999

The role of the detection of hematogenous micrometastasis in prostate adenocarcinoma and malignant melanoma by RT-PCR.

Recent studies reported the possibility of detecting prostate adenocarcinoma and malignant melanoma cells in peripheral blood using RT-PCR of prostatic specific antigen (PSA), prostatic specific membrane antigen (PSMA) and Tyrosinase mRNAs. The PCR results showed high variability, ranging between 0% and 100% of positivity in patients with advanced disease. Our purpose was to evaluate the presence of tumor marker mRNAs in peripheral blood of prostate cancer and melanoma patients by means of RT-nested-PCR. We tested 70 and 36 peripheral blood samples from prostate carcinoma and malignant melanoma patients, respectively. The RT-PCR analysis showed the presence of PSA cDNA in 9 out of 70 (12.9%); PSMA cDNA in 14 out of 70 (20%); and Tyrosinase cDNA in 2 out of 36 (5.5%) peripheral blood samples from melanoma patients. Our study confirms the applicability of this sensitive method to monitor disease status. Although, the RT-nested-PCR of Tyrosinase is able to detect neoplastic cells in peripheral blood specimens, we suggest the necessity of a great caution in interpreting PCR results when the nested method has been used.

Adenocarcinoma↗
PubMed1997

The use of RT-"nested" PCR of prostate specific antigen to detect hematogenous neoplastic cells in patients with prostate adenocarcinoma.

The aim of this study was to determine the presence of hematogenous neoplastic cells in patients with prostate cancer. We used a reverse transcription (RT) "nested" polymerase chain reaction (PCR) of prostate-specific antigen (PSA) mRNA to detect the presence of circulating tumor cells in 52 patients who underwent radical prostatectomy with lymphadenectomy. Blood samples were obtained before and after the surgical manipulation. Seven (13.5%) preoperative samples presented evidence of circulating neoplastic cells. All postoperative specimens studied presented a negative result at analysis 24 h after surgical manipulation. Although we did not find a statistical correlation between the PSA-PCR results and clinical-histopathological parameters, the presence of circulating prostate cells was strongly correlated with an elevated Gleason score of primary tumor (P<0.01). Thus our data show the positive effect of surgical treatment in removing the metastases source. The sensitive RT-nested PCR assay may play a crucial role in the administration of adjuvant therapy of patients with prostate adenocarcinoma.

Adenocarcinoma↗
PubMed1994

Modulation of human lymphoblastoid interferon activity by melatonin in metastatic renal cell carcinoma. A phase II study.

BACKGROUND: Numerous attempts to identify active cytotoxic agents for the treatment of metastatic renal cell carcinoma (RCC) have proved disappointing. However, several recent developments in biologic therapy of neoplastic disease have substantially improved the prospects for the treatment of advanced RCC. Melatonin (MLT), a hormone regulated by the pineal gland, has been shown to act on the immune system by causing the release of cytokines from activated T-cell populations. METHODS: A series of 22 patients with documented progressing RCC entered a trial in which the authors studied the effect of a long term regimen (12 months) with human lymphoblastoid interferon (IFN), 3 mega units (MU) intramuscularly 3 times per week, and MLT, 10 mg orally every day. RESULTS: Twenty-one patients were evaluable for response and toxicity. There were seven remissions (33%): three complete, involving lung and soft tissue and four partial, with a median duration at the time of this writing of 16 months. Nine patients achieved stable disease, and five progressed. General toxicity was mild. Fever, chills, arthralgias, and myalgias occurred rarely. Leukopenia and hepatic enzyme elevation were modest and always reversible. CONCLUSIONS: Response rate and toxic effects observed during this study warrant additional randomized studies to define the role of MLT's concomitant administration in the clinical response to IFN in metastatic RCC.

Adult↗
PubMed1994

[The post-adenomectomy dysuria-hematuria syndrome].

The dysuria syndrome consists of the persistence or accentuation following adenomectomy of the symptoms which caused the patient to seek the urologist's advice. It is frequent event whose causes are largely connected to physiopathological events which are also influenced by the developing role between the urologist and patients in view of prostate disease. The authors analyse the various causes of post-adenomectomy dysuria and emphasise the importance of a precise diagnosis and the correct indications for surgery for the prevention of this disease.

Hematuria↗
PubMed1981

[Ultrastructural aspects of the pathology of the pyeloureteral junction].

Are described some observation on the ultrastructure of the muscular coat in three cases of the ureteropelvic junction pathology; the patients were undergone at ureteropelvic resection. The authors underline the presence of an important damage of smooth muscle cells at the ureteropelvic junction, also at the renal pelvis and the upper third of the ureter. The abnormalities of muscle cells are of various type: some of these could be cause of the altered motility and fibrosis of the ureteropelvic junction, constantly observed in such pathological abnormality.

Adult↗
PubMed1981

Ultrastructure of the urinary tract muscle coat in man. Calices, renal pelvis, pelvi-ureteric junction and ureter.

Muscle coat specimens from human calices, renal pelvis, pelvi-ureteric junction, upper, middle and lower ureter segments were examined under an electron microscope. These specimens were taken from 8 patients who had undergone nephroureterectomy: 6 for localized renal carcinoma and 2 for papillary tumor of the pelvis. Two types of smooth muscle cells were observed, "typical" muscle cells and "special" muscle cells. The latter are rich in agranular endoplasmic reticulum, have few myofilaments and are interconnected in numerous, extended, peculiar contact areas. The ratio between these two types of muscle cells differs as also does their innervation between the various segments examined. On the basis of our findings we propose that the "special" muscle cells perform a "pacemaking" function.

Humans↗