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Biomedical subjects

V Pistotti

Publications and source records attributed to V Pistotti.

7 recordsLinked to original sources

Placental perfusion. An overview of the literature.

Placental perfusion techniques are currently used to study not only the organ functions but also the transfer profile and metabolic pathway of different compounds. In view of the interest in the mechanism of transfer and potential adverse effects of compounds there are numerous publications on the topic, but no systematic picture is yet available. Thus an overview has been made of all studies published from 1966 to 1990 that use this experimental approach. Out of 359 computer-retrieved articles, 266 (74%) actually dealt with the target topic; 68 articles were added after a systematic hand search, so a total of 334 articles were analyzed. The distribution of papers per year was constant until 1980, and rose significantly thereafter. Animal studies using placental perfusion were performed either in situ or in vitro, whereas human investigations were mostly examined by in vitro perfusion techniques. Animal experiments were done on seven species, the guinea pig being the most widely used. The aims of all studies could be divided into five main categories: 132 studies researched the kinetics of compounds in the placenta; 100 studies investigated placental metabolism; methodology of perfusion was reported in 22 articles; and 49 studies examined physiological changes of placental variables. A clear increase in pharmacological studies was noted starting from 1986 (there were 31 such studies). Compounds studied were either endogenous or exogenous. Almost all endogenous compounds were investigated, some of them quite extensively (mainly hormones, angiotensin, glucose, and lactate). There seemed to be no preferential field for exogenous compounds (62 compounds could be assigned to 20 classes).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

A computer filing system for drug use in a pregnancy consultation service.

A computerized database for documenting drug use in pregnancy was set up on a personal computer. Summaries of the information available from the literature on more than 700 drugs taken during pregnancy have already been entered and are currently in use. This reliable, cheap, handy, and personal system (the first available on the topic) may be a potentially useful instrument not only for drug consultation services, but for individual physicians, too.

Databases, Factual

Critical review of the quality and development of randomized clinical trials (RCTs) and their influence on the treatment of advanced epithelial ovarian cancer.

Trials on chemotherapy of advanced ovarian cancer published between 1975-88 were systematically reviewed for quality (according to the method of Chalmers) and consistency of tested hypotheses with a view to a meta-analysis of all published studies in the field. Median overall, internal and external validity scores were 47%, 43% and 53%, respectively. No association was found between scores and key features of trials, such as percentage studies with significant results in response or survival or percentage studies with high or low follow-up retention (withdrawal rates less than or greater than or equal to 15%). Only 21% of trials reported a fully blind randomization procedure and only in 13% were drop-outs accounted for by the intent-to-treat method. Only 4 trials entered more than 150 patients per arm, a sample size consistent with detection of an absolute difference of 11% in mortality. The majority of trials (58%) investigated the role of combination regimens versus a single-agent control arm. The remaining trials tested different polychemotherapies. However, within these two general issues, treatment options were quite heterogeneous: seven subgroups were identified by whether cisplatin was present in either the treatment or the control arm. We conclude that the internal coherence and development of randomized clinical trials in advanced ovarian cancer and their methodologic soundness are quite poor. In this situation meta-analysis cannot go beyond a systematic attempt to answer a very general "treatment effectiveness" question.

Antineoplastic Agents