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Biomedical subjects

S Barra

Publications and source records attributed to S Barra.

53 records · Page 3Linked to original sources
PubMed1990

A case-control study of risk factor for renal cell cancer in northern Italy.

A hospital-based case-control study of renal cell cancer was conducted in northern Italy between 1986 and 1989, with 240 cases of renal cell cancer (150 males and 90 females), and 665 controls (445 males and 220 females) chosen on the basis of age, sex, and area of residence. No associations were found between renal cell cancer and: body mass index (BMI); number of cigarettes smoked; age at starting to smoke; years of smoking; consumption of wine, beer, spirits, coffee, decaffeinated coffee; tea; intake of animal protein, fruits, and vegetables; various reproductive factors; hormonal use; sexual habits; sexually transmitted diseases; or selected occupational exposures. The odds ratio (OR) was above unity in smokers (OR = 1.34 for greater than or equal to 15 cigarettes/day), but the trends in risk with dose or duration were not statistically significant. Significant positive associations were found between renal cell cancer and sources of fat intake, especially margarine (OR for highest vs lowest intake = 1.71), and oils (OR = 1.89) whereas carrot intake showed a negative association (OR = 0.62). Also, a history of nephrolithiasis and multiple episodes of cystitis showed weak positive associations (OR = 2.00, 95 percent confidence interval (CI) 1.07-3.73; and OR = 1.60, 95 percent CI 0.95-2.70, respectively).

Adult↗
PubMed1990

Type of cigarettes and cancers of the upper digestive and respiratory tract.

The relationship between type of cigarettes smoked and the risk of cancer of upper digestive and respiratory sites was investigated in a case-control study conducted in Northern Italy on 291 males with cancer of the oral cavity or pharynx, 288 with cancer of the esophagus, 162 with cancer of the larynx, and 1,272 control subjects in hospital for acute conditions unrelated to tobacco or alcohol consumption. Using a distinction based on tar-yield or the brand smoked for the longest time (less than 22 mg, low to medium tar; greater than or equal to 22 mg, high tar), the multivariate relative risks among ever-smokers were 8.5 for low/medium and 16.4 for high tar cigarettes for oral and pharyngeal neoplasms, 3.3 and 7.8 for esophageal, and 4.8 and 7.1 for laryngeal cancers. The differences according to type of cigarettes were similar in proportional terms, and hence larger in absolute terms, when analysis was restricted to current smokers only. Thus, these data provide further quantitative evidence on the importance of type of cigarette smoked on the risk of upper-digestive and respiratory tract cancers and have important public health implications.

Adult↗
PubMed1990

Patients compliance in an early detection program for upper aero-digestive tract tumours in north-eastern Italy.

An early detection program for tumours of the upper respiratory and digestive tract has been conducted from December, 1988 to May, 1989 in the Friuli Venezia-Giulia region, Northeastern Italy. This region shows very high mortality rates for cancers in these sites. Six hundred seventy-one high risk patients (i e habitual smokers and/or drinkers) were referred to Ear, Nose and Throat (ENT) specialists from 16 General Practitioners (GPs) for a free examination as part of the screening program. Four hundred thirty-six patients underwent the visit (65%) with fifty-five precancerous lesions and eight epithelial tumours detected among them. This program appears to have accomplished its aims of establishing a closer relationship between GPs and ENT specialists, discovering early cancerous and precancerous lesions, and targeting high risk patients with an educational message against smoking and heavy drinking.

Adult↗
PubMed1990

Chemo-radiotherapy and autologous bone marrow transplantation in poor prognosis neuroblastoma.

In Genoa, 39 patients affected by disseminated neuroblastoma, one to twelve years old, were treated with intensive chemotherapy (Vincristine 4 mg/sqm c.i. over 5 days, Melphalan 140 mg/sqm), total body irradiation (TBI) (3.3 Gy for 3 days), and unpurged autologous bone marrow transplantation (ABMT) since October 1984 until November 1987. Thirty-two patients were in complete response (first group) and 7 had residual disease (second group) after an intensive chemotherapeutic induction regimen. Actuarial overall survival at 38 months is 52% and disease free survival at 30 months is 28% for the first group. Actuarial overall survival at 25 months is instead 14% for the second group related treatment toxicity has not been too high (3 deaths).

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Glucose-6-phosphate dehydrogenase (G6PD) activity in tumoral tissues of G6PD-deficient subjects affected by larynx carcinoma.

The activity of glucose-6-phosphate dehydrogenase (G6PD), the key enzyme of the hexose monophosphate (HMP) shunt pathway, was measured in both normal and tumoral larynx tissues from normal and G6PD deficient subjects. Significant increases of this enzymatic activity were found in tumoral tissues of both normal and G6PD deficient subjects, who were characterized by very low levels of G6PD activity in erythrocytes as well as in larynx tissue.

Aged↗
PubMed1989

Total body irradiation in acute myeloid leukemia and chronic myelogenous leukemia: influence of dose and dose-rate on leukemia relapse.

From June 1981 to March 1987, 106 patients--59 with acute myeloid leukemia (AML) and 47 with chronic myelogenous leukemia (CML)--were treated with Cyclophosphamide 60 mg/kg X 2 d and total body irradiation (TBI-990 cGy/3fr/3d described dose) before allogeneic bone marrow transplantation. Seventy-nine patients are evaluable for risk of relapse: 32 with chronic myelogenous leukemia (23 in first chronic phase, 9 in accelerated phase) and 47 with acute myeloid leukemia (38 in first complete remission, 9 in subsequent phases). Actual TBI doses delivered to these patients varied between 839 and 1250 cGy (mean 956 +/- 101)/3 fr/3d, with dose rates between 2.7 and 7.25 cGy/min (mean 4.2 +/- 1.8). Patients receiving high (greater than 990 cGy) and low (less than or equal to 990) dose and/or dose rate (greater than 4 cGy/min and less than or equal to 4, respectively) have been evaluated overall and stratified by type of leukemia and phase of disease. When the patients are considered altogether, high total dose is significantly correlated with decreased risk of relapse (p = 0.0005) as well as high dose rate (p = 0.03). When considering specific subgroups, the influence of total dose on relapse rate is evident both for "early" and "advanced" leukemias, while an impact of dose rate appears only for chronic myelogenous leukemia in 1st chronic phase. Pertinent radiobiological and clinical literature is reviewed, and a possible role of dose fractionation and dose rate in leukemic control rate is evidenced; in this TBI setting, total dose not less than 990 cGy/3fr/3d and dose rate not less than 4 cGy/min have to be guaranteed.

Adolescent↗
PubMed1989

[Habits and opinions about cigarette smoking among medical, nursing and technico-administrative staff at the Magenta Hospital (Local Health Unit no. 72)].

Smoking habits of 882 employees of Magenta general hospital (province of Milan) (135 doctors, 594 nurses and 153 technicians and clerical staff) were investigated in May 1986, by means of a self-administered questionnaire (response rate 84%). Forty-five percent of men and 34% of women reported to be current smokers, respectively 13% fewer and 41% more, after age-standardization, than the general population of the same province. Smoking habits of the three professional groups considered did not differ substantially, but a higher number of doctors as compared to nurses admitted to smoke occasionally in front of patients. The vast majority (80%) agreed with a total ban of smoking inside the hospital but the underestimation of smoking-related health hazards, especially outside the cancer field, turned out to be also very common. Only 34% of doctors, 13% of nurses and 16% of technical and clerical staff identified smoking as the leading preventable cause of death in Italy.

Adolescent↗
PubMed1989

[Fractionated and hyperfractionated total body irradiation in the conditioning of allogenic bone marrow transplant in acute lymphatic leukemia. Results].

Two different Total Body Irradiation (TBI) regimens were employed (1981 to July 1983) in Genoa in the conditioning program for the allogeneic Bone Marrow Transplantation (BMT) of 22 patients suffering from Acute Lymphoblastic Leukemia (ALL) in remission (7 patients in 1st remission, and 15 in 2nd remission). All patients were treated with Cyclophosphamide -60 mg/kg administered for two consecutive days (day -7 and -6)--and subsequently underwent fractionated TBI (days -3, -2, -1), that is, our conventional TBI regimen: 3.3 Gy/day per 3 days (total dose: 9.9 Gy). From August 1983 through 1988, 33 patients (14 in 1st remission and 19 in 2nd remission) were given 2 Gy twice a day, 6 hours apart, for 3 consecutive days (total dose: 12 Gy). Cyclosporine A was used for GvHD prophylaxis. At 58 months, out of the total figure of ALL patients in 2nd remission, 19% of those treated with 9.9 Gy/3 fr/3 days (fractionated TBI) is likely to be in remission, versus 65% of the cases treated with 12 Gy/6 fr/3 days (p less than 0.01) (hyperfractionated TBI); the actuarial overall survival is 23% after fractionated vs 60% after hyperfractionated TBI (p = 0.05). The incidence of idiopathic interstitial pneumonitis was very low (3.6%). Thus, we conclude that, in ALL patients in second remission, hyperfractionated TBI (12 Gy/6 fr/3 days) yields better results than fractionated TBI (9.9 Gy/3 fr/3 days), with lower relapse rate (33% vs 83%) and higher survival.

Adolescent↗
PubMedDate not supplied

Radiotherapy after high-dose chemotherapy followed by autologous bone marrow transplantation in patients with intermediate or high-grade non-Hodgkin's lymphoma.

Patients with intermediate or high-grade non-Hodgkin's lymphoma are rarely cured of their disease after the failure of conventional therapy. Autologous bone marrow transplantation (ABMT) offers such patients a new possibility of cure. Our purpose was to evaluate the usefulness of radiotherapy. In these patients who did not achieve complete remission of disease after high-dose chemotherapy (HDCT) followed by ABMT or who had previous bulky disease. In this study we examined 10 patients: after HDCT+ABMT, 9 patients had persistent disease and 1 patient with previous bulky disease was in complete remission. All patients underwent involved-field radiotherapy administered by a 6-18 MV linear accelerator, total mean dose 4000 cGy (range, 3200-5000 cGy). At the end of radiotherapy we observed 6 complete responses and 4 progressions of disease outside the radiotherapy field. No serious side effects were observed. To date, of the 6 complete responses 2 have relapsed (after 9 and 11 months) and 4 are alive and disease free at 24 months (range, 8-39 months) after radiotherapy. In our opinion, radiotherapy is an effective treatment after HDCT+ABMT and may have a role in a prospective multidisciplinary approach.

Adult↗
PubMedDate not supplied

[The program for early diagnosis of the upper respiratory tract and digestive system neoplasms offered to alcoholics in the region of Friuli-Venice Giulia].

The present study deals with data from an on-going collaborative programme of early diagnosis for upper aero-digestive tract tumors established since 1990 by three ENT Departments of the Friuli-Venezia Giulia Region, Northeastern Italy. The aim of the study was firstly to evaluate the socio-economic characteristics and clinical features of alcoholics in treatment who were offered a free ENT check-up, and secondly to test the feasibility of this type of referral of high-risk patients from non-medical associations to the ENT specialist. A total of 683 patients, of which 151 (78%) were males and 151 (22%) were females, underwent ENT examination. About 25% of the patients were symptomatic, the most frequent symptom being dysphonia (50%) followed by cough (19%), while dyspnoea, dysphagia and pain were present in about 5% of the patients. Other than nearly 50% negative findings, ENT examination revealed a high percentage of inflammatory lesions (30%) of the upper aero-digestive tract. In 37 patients (6%) a precancerous lesion was found and in four cases an histologically confirmed tumor was diagnosed. Although the present study cannot be considered a complete screening, it did clearly evaluate the amount of response given by this high-risk population of alcoholics in treatment to the offer of an ENT examination and gives encouraging results concerning the feasibility of early diagnosis programmes for upper aero-digestive tract tumors which do not follow the normal routine of a sanitary referral by a general practitioner.

Adult↗
PubMedDate not supplied

Radiation treatment plus CCNU plus the radiosensitizer lonidamine in malignant gliomas operated.

From June 1988 to January 1990, 28 patients with primary brain tumours were operated and treated with radiotherapy (RT) (50 Gy whole brain + 10 Gy boost to tumour bed) + cyclohexylnitrosourea (CCNU) 130 mg/msq p.o. every 6 weeks + the radiosensitizer Lonidamine (LND) (150 mg T.I.D. for the whole duration of treatment). Myelotoxicity of this regimen was acceptable, with two cases of grade IV leukopenia and thrombocytopenia requiring discontinuation of treatment. LND was discontinued in 6 patients for major toxicity (myalgias and/or testicular pain), and 3 additional patients required dose reduction of this drug. The median follow-up time of the patients on study was 12 months. The median survival time (MST) was 5 months for grade IV astrocytomas (n = 8) and 16 months for grade III lesions (= 20). No correlation was seen between survival of patients and DNA content, measured by flow cytometry, or levels of O6- alkylguanine-DNA alkyltransferase, an enzyme that repairs the CCNU-induced DNA damage.

Brain Neoplasms↗
PubMedDate not supplied

Concomitant radiation-doxorubicin administration in locally advanced and/or metastatic soft tissue sarcomas: preliminary results.

Doxorubicin was administered by continuous infusion at a dosage of 12 mg/sqm/day for 5 days concomitantly with radiation treatment (150 or 200 cGy/day for trunk or extremity lesions, respectively) for 5 days. The 5-day cycles were repeated every 3 weeks. Seventeen patients, 5 of whom were pretreated, entered the study; all were assessable for toxicity and 15 for response. The overall objective response rate was 46% (7/15): 1 complete and 6 partial responses. Response rate reached 54% in only non-pretreated patients (6/11) and 75% in patients with PS less than or = 2 (6/8). No disease progression was observed during treatment. The median duration of complete or partial responses was 28 weeks (range 5-86). Toxicity was low and treatment very well tolerated. In our preliminary analysis, the response rate obtained with this combined chemo-radiotherapic regimen was encouraging and the toxicity was acceptable.

Adult↗
PubMedDate not supplied

[Immunosuppressive role of radiotherapy in bone marrow transplant in patients with aplastic anemia].

From April 1976 through August 1989, 66 patients with aplastic anemia were treated on either of two immunosuppressive regimens in preparation for allogeneic bone marrow transplantation (BMT) from matched donor. Seventeen patients were treated with cyclophosphamide (50 mg/kg for 3 days) followed by thoracoabdominal irradiation (TAI), 6 Gy/1 fr and 2 patients, receiving marrow graft from partially matched family donors, were treated with cyclophosphamide (50 mg/kg for 3 days), TAI (6 Gy/1 fr) and Ara-C (4 g/mq for 2 days). Forty-seven more patients were treated with cyclophosphamide alone (50 mg/kg for 4 days). All patients received prophylactic treatment with methotrexate (15) or cyclosporine A (51) to avoid graft-versus-host disease. Mean time to engraftment was 12 days after chemotherapy and TAI and 15 days after cyclophosphamide (Cy) alone. No marrow rejections were observed in the TAI group: the two infants that received partially matched marrow allografted and are alive and well. Two patients treated with cyclophosphamide alone rejected allogeneic marrow. Long-term overall survivals are similar: 64% for TAI + Cy group and 56% for Cy alone group. In spite of the immunosuppressive regimen employed, young patients (under 20 years) do better than older ones (survival: 65% vs 45%, respectively). Thus, patient's age seems to be the main factor determining overall survival after allogeneic BMT. We conclude that the use of irradiation does not add significantly to the survival of aplastic patients; given the possible toxic long-term effects of irradiation, it would probably be wise to restrict the combined use of cyclophosphamide and irradiation to the patients sensitized to their donors, to those receiving partially matched marrow from family donors or in programs involving T-cell depletion.

Adolescent↗
PubMedDate not supplied

[Pilot study of screening for the early diagnosis of tumors of the upper respiratory and digestive tracts in individuals at risk in the Friuli-Venezia Giulia region].

A pilot study on a screening program for tumours of the upper respiratory and digestive tracts was conducted from December 1988 to May 1989 in the Friuli-Venezia Giulia Region (Northern Italy), an area showing high mortality rates for cancers of these sites. Six hundred seventy-one patients at risk (i.e. habitual smokers and/or drinkers) were referred to an E.N.T. specialist by 16 general practitioners for free examination. Of these 436 (65%) actually underwent examination and, among them, 55 (12.6%) precancerosis and 8 (1.8%) epithelial tumors were detected. Although some low risk patients (mainly females) were eventually seen as well, two non-epithelial tumors being found, this pilot study would appear to have accomplished its purposes, namely to establish a closer relationship between GPs and ENT Specialists so as to discover cancerous and precancerous lesions early on and to address an educational message against smoking and heavy drinking to at risk subjects.

Adult↗
PubMedDate not supplied

A comparison of the joint effects of alcohol and smoking on the risk of cancer across sites in the upper aerodigestive tract.

A unified analysis of the combined effects of alcohol and smoking in cancers of the upper aerodigestive tract was conducted using polychotomous logistic regression to determine if, at the same level of exposure, risk varies significantly across pathological sites. Data from a case-control study in northern Italy include males with tumors of the oral cavity/pharynx, larynx, and esophagus and males admitted to the hospital for acute illnesses not related to alcohol and smoking. The combined alcohol and smoking risks for oral cavity/pharynx cancer in these data were significantly greater than those for either laryngeal or esophageal cancer, but esophageal cancer and laryngeal cancer could not be distinguished based on risk. The differences may lie in the presence of unspecified factors in the oral cavity and pharynx, but not in the other upper aerodigestive tract sites, which potentiate the effects of alcohol and smoking in the oral cavity/pharynx.

Adult↗