PubMed Health⌕ Search

Biomedical subjects

S Tanneberger

Publications and source records attributed to S Tanneberger.

At least 19 recordsLinked to original sources
PubMed2005

Increase in autoantibodies against Fas (CD95) during carcinogenesis in the human colon: a hope for the immunoprevention of cancer?

A thorough understanding of the naturally occurring events in the immune system in response to carcinogenesis will facilitate the development of strategies for the immunoprevention of cancer. The adenoma-carcinoma sequence in the human colon is a well-established clinical example of multi-step carcinogenesis and can be used for immunological studies. Based on previous observations that both apoptosis and the expression of Fas (Apo-1, CD95) are altered during carcinogenesis in the human colon, we asked the question whether serum titers of autoantibodies against Fas show any modification during the adenoma-carcinoma sequence. Healthy controls (38), patients with colorectal adenomas (38) and patients with colorectal adenocarcinomas (21) were investigated. Anti-Fas antibody titers were found to be significantly higher in patients with colorectal adenomas than in healthy controls and higher still in patients with colorectal adenocarcinomas. This increase in anti-Fas autoantibody titers during carcinogenesis might reflect the activation of natural defense mechanisms by the immune system.

Adenocarcinoma↗
PubMed1997

Immunoprevention of cancer poses a challenge to pharmacological research.

The evolving understanding of the molecular mechanisms of carcinogenesis establishes that the long latency period would offer numerous opportunities for intervention before the final step of fully developed malignancy has been reached. Immunoprevention of cancer may be a new approach to cancer control, by eliminating the cellular minimal deviations that are seen in the early phases of carcinogenesis. Available results of immunotherapy of preneoplastic lesions and data on anticarcinogenesis with immunoregulators in experimental models are in good accordance with theoretical expectations. However, clinical research on immunoregulators still focuses on the treatment of advanced cancer. The major problem hampering a wider application of immunoregulators in cancer prevention is the possibility of potential adverse effects, which are largely unknown. The promotion of future research in this area is essential. Moreover, the ethical issues of intervention trials in cancer must be discussed, by considering the potential psychological and social consequences.

Animals↗
PubMed1997

Home artificial nutrition in advanced cancer.

Attitudes to home artificial nutrition (HAN) in cancer vary greatly from country to country. A 6-year prospective survey of the practice of HAN in advanced cancer patients applied by a hospital-at-home programme in an Italian health district was performed to estimate the utilization rate, to evaluate efficacy in preventing death from cachexia, maintaining patients at home without burdens and distress and improving patients' performance status, and to obtain information about costs. Patients were eligible for HAN when all the following were present: hypophagia; life expectancy 6 weeks or more, suitable patient and family circumstances; and verbal informed consent. From July 1990 to June 1996, 587 patients were evaluated; 164 were selected for HAN (135 enteral and 29 parenteral) and were followed until 31 December 1996. The incidence of HAN per million inhabitants was 18.4 in the first year of activity and 33.2-36.9 in subsequent years, being 4-10 times greater than rates reported by the Italian HAN registers. On 31 December 1996, 158 patients had died because of the disease and 6 were on treatment. Mean survival was 17.2 weeks for those on enteral nutrition and 12.2 weeks for those on parenteral nutrition. Prediction of survival was 72% accurate. 95 patients had undergone 155 readmissions to hospital, where they spent 15-23% of their survival time. Burdens due to HAN were well accepted by 124 patients, an annoyance or scarcely tolerable in the remainder. The frequency of major complications of parenteral nutrition was 0.67 per year for catheter sepsis and 0.16 per year for deep vein thrombosis. Karnofsky performance score increased in only 13 patients and body weight increased in 43. The fixed direct costs per patient-day (in European Currency Units) were 14.2 for the nutrition team, 18.2 for enteral nutrition and 61 for parenteral nutrition. The results indicate that definite entry criteria and local surveys are required for the correct use of HAN in advanced cancer patients, that HAN can be applied without causing additional burdens and distress, and that its costs are not higher than hospital costs.

Aged↗
PubMed1997

[Home hospital for advanced stage cancer patients: costs and benefits].

15,290 patients have been treated in the Bologna home hospital (BHH) until June 30, 1996. The average daily costs in BHH were estimated as 118789 Liras (ranging from 108 569-129027 Lire depending on the nursing category). Care intensity and patient's quality of life in the BHH are high. 98% of patients were content with the setting in which they were nursed. A questionnaire on the degree of satisfaction with the care was completed by 134 BHH patients and 102 patients of Division Oncologia Medica. Azienda Ospedaliera Sant, Orsola Malpighi, Bologna. Satisfaction with respect to sleeping, meals and family communications was expressed more often by BHH patients. Less patients of the BHH evaluated "quality of life" reduced or bad (51% vs. 67%) or requested a transfer to the alternative setting (03% vs. 47%). Advocating step by step introduction of home care, quality of life aspects have priority. Certainly, home care deserves greatest attention providing care during the life with cancer. However the final decision about the settings of nursing has to be made by the patients themselves in accordance with his understanding of quality of life.

Adult↗
PubMed1996

Interferons in precancer and cancer prevention: where are we?

Clinical research on interferons (IFN) still focuses on the treatment of advanced cancer. The research strategy eventually must be reevaluated. The cellular minimal deviations that are seen in early phases of carcinogenesis might be the most rational target for immune interventions. That biologic response modifiers have considerable capacity to prevent induction and development of malignant neoplasias has been demonstrated in several animal systems. Even the few clinical studies available at present on the treatment of preneoplastic lesions with IFN have definitely shown more success than those involving treatment of advanced tumors. In addition, there is experimental evidence that IFN might be suitable candidates for immunoprevention. The major problems hampering a wider application of IFN in immunoprevention is that they cause adverse effects. Unfortunately, we do not know much about the specific mechanisms involved in the immune control of human tumor development during the initial and the latency phases of carcinogenesis. More research is needed in this area. In this article the state of the art of using IFN for treating preneoplastic lesions is reviewed, and also we report some of our experimental results on IFN and anticancerogenesis.

Animals↗
PubMed1995

[Euthanasia: refusal requires alternatives. The home hospital model could be a solution for some cancer patients].

Maybe more important than an emotional debate on "pro and con" of euthanasia is search of alternatives for all who would request for physician-assisted suicide. Obviously it is not easy to find such alternative approaches. However only these justify a position "contra euthanasia". As one alternative Franco Pannuti introduced 1985 the concept of Eubiosia. Eubiosia, what means, the set of qualities that give life dignity, was proposed as a fundamental right of all patients. And dying in dignity as part of life in dignity excludes euthanasia. In the same way as respecting beginning life we have to respect ending life. A possible approach to guarantee Eubiosia for cancer patients is the hospital at home. A hospital at home is a part of the health care system having his own structural and organisational characteristics. It guarantees for a certain group of patients clinical level of care at the comfort of their own homes. The evaluation of 10,236 patients admitted in the Bologna home hospital, show that a majority of patients favour this care model which additional can have economical advantages.

Euthanasia↗
PubMed1995

[Cancer in developing countries. Illness in a diseased world].

In Third World countries, cancer is mainly a risk for the future generations. Without achieving adequate cancer control in developing countries, much of the progress in the fight against infections will be lost. While the industrialized countries are more and more concerned to avoid cancer risk factors and, thus, decrease the frequency of cancer, only few such steps can be seen in developing countries. Based on the actual cancer mortality and demographic projections in the year 2000, cancer mortality in the whole world will be 8 to 10 millions (2 to 3 millions in industrialized countries, 6 to 7 millions in developing countries). But while 60% of the world's new cancer patients are in the Third World, the developing countries dispose only 5% of the world's total anticancer resources. The cancer situation in the Third World indicates that in spite of many humanitarian efforts and many previous statements the fight against suffering in the world often stagnates. Therefore, it seems to be justified to call the world "sick". However the suffering of the Third World is curable. However we have to accept that the present world is not functioning very well, we have to explore the reasons for that and to solve existing problems.

Adolescent↗
PubMed1992

The antiemetic efficacy and the cost-benefit ratio of ondansetron calculated with a new approach to health technology assessment (real cost-benefit index).

In a phase II study including 80 patients treated with highly emetic drugs such as cisplatin, carboplatin or cyclophosphamide > 600 mg/day) we confirmed the potential of ondansetron to prevent cancer chemotherapy- related acute nausea and vomiting. With a total dose of 19.0-37.3 mg ondansetron we achieved 82%-100% acute (0-24 hours) vomiting free patients. Using ondansetron for the prevention of acute nausea and vomiting increases the total chemotherapy costs by 6%. The real cost-benefit ratio for the treatment of acute nausea and vomiting shows better values for ondansetron than for all other recommended regimens.

Adult↗
PubMed1992

The Bologna Eubiosia Project: hospital-at-home care for advanced cancer patients.

Since 1985 the Associazione Nazionale per lo Studio e la Cura dei Tumori Solidi (ANT), an Italian nonprofit anticancer organization, has provided a hospital-at-home care program for advanced and very advanced cancer patients. This program is part of the Eubiosia Project which also includes a number of complementary services. Teams of doctors, nurses, and psychologists work round-the-clock in the region and on hospital wards, assisted by diagnostic and therapeutic facilities applicable at home and by a round-the-clock on-call service seven days a week. The patients who were treated between December 1985 and December 1991 numbered 5603, of whom 2130 received treatment in 1991 alone, with 702 patients on line at the end of the period. The mean duration of home care for the first 2803 deceased patients was 62 days, and the percentage of deaths at home was 70%. We analyzed control of the main symptoms and the residual survival in three groups of patients--stomach, lung, and breast cancer sufferers--and found that acceptable pain control was achieved in 95% of cases. From the retrospective analysis of our data it can be seen that the eligibility criteria for entry to home care should not only depend upon performance status and the presence of symptoms, but should also take into account the factors that are inherent to the natural history of any kind of tumor as well as the social, domestic, and psychological characteristics of the patients.

Adolescent↗