Markers of Cardiotoxicity in Early Breast Cancer Patients Treated With a Hypofractionated Schedule: A Prospective Study.

PURPOSE: To evaluate, in a series of early breast cancer (BC) patients treated with hypofractionated adjuvant radiotherapy (RT), whether N-terminal-pro hormone B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin I assay measurements can predict acute clinical or preclinical cardiotoxicity. PATIENTS AND METHODS: The study comprised 44 consecutive patients, who underwent conservative surgery with or without (neo)adjuvant chemotherapy and hypofractionated adjuvant RT. The RT schedule consisted in a total dose of 42.4 Gy in 16 fractions administered 5 days per week. Twenty-one patients received a subsequent boost to the tumor bed consisting of a total dose of 10 Gy in 4 fractions delivered via a direct electron field. All patients underwent 12-lead electrocardiogram, echocardiogram, and cardiac clinical examinations before RT to assess cardiovascular risk factors; these examinations were repeated yearly for 5 consecutive years. High-sensitivity cardiac troponin I and NT-proBNP were analyzed from serum samples at baseline, after delivery of the fourth and 16th RT fractions, and 12 months after treatment completion. RESULTS: No increase in cardiac troponin I and B-type natriuretic peptide levels related to left breast irradiation was observed. No statistical difference in NT-proBNP and high-sensitivity troponin I levels between left- and right-sided BC was found. An increase was observed of B-type natriuretic peptide levels at baseline, during treatment, and until 12 months after RT related to hypertension, with the P value near to the .05 threshold for age and chemotherapy. CONCLUSION: Conformational hypofractionated RT in left-sided BC may not cause acute myocardial damage. Early cardiac screening may be used to identify patients with cardiologic risk factors, patients who are older than 60 years, and patients who received chemotherapy that could result in clinically relevant cardiac pathologies.

[Importance of endocervical cells in the diagnosis of CIN]. / Importanza delle cellule endocervicali nella diagnosi di CIN.

BACKGROUND AND AIM: The authors performed a comparative study to define the role played by the presence of endocervical cells on the smear in the correct diagnosis of CIN. METHODS: The study was performed from January to December 1996 at the Clinic of Obstetrics and Gynecology of the Second University of Naples and involved 67 women with a histological diagnosis of CIN made in the two previous months of the study. The smears taken earlier were re-examined to assess the endocervical component regarding columnar and metaplastic cells and a comparison was made between smears which were CIN-positive and negative. RESULTS: The difference between positive and negative CIN smears was statistically non-significant for columnar cells (66% vs 56%), unlike the findings for metaplastic cells (82% vs 61%). This demonstrated that CIN smears are more likely to include metaplastic cells compared to negative smears and the two types of smear do not differ significantly with regard to columnar cells. CONCLUSIONS: In order to make a cytological diagnosis of CIN, attention must predominantly be focused on the metaplastic component of endocervical cells.

[Psychological consequences in women with symptomatic HPV infection]. / Conseguenze psicologiche in donne con infezione sintomatica da HPV.

OBJECTIVE: Evaluation of psychological and social aspects of women with diagnosed genital HPV-infection. EXPERIMENTAL DESIGN: A retrospective study of 40 women with a diagnosis of HPV-genital infection has been made. INTERVENTIONS AND MEASURES: A questionnaire for gathering information on social life, sexuality and emotional relationship with the partner was submitted to the patients. RESULTS: There is a high percentage of sexual impairments after diagnosis of HPV-infection. CONCLUSIONS: HPV infections, as many genital pathologies, lead to problems with sexuality as well as hypochondriac fears.

[Authors' experience in the treatment of cervical intraepithelial neoplasia]. / Neoplasia intraepiteliale cervicale. Nostra esperienza di trattamento.

BACKGROUND: During the last ten years, after the destroying intervention for the treatment of cervical intraepithelial uterine neoplasia (CIN = Cervical Intraepithelial Neoplasia) was abandoned, space has been given to the conservative treatment, both destructive and excisional. In this study, conducted at the Department of Gynaecology and Obstetrics of Eboli Hospital (ASL Salerno 2) in collaboration with the Gynaecological and Obstetrical Department of the Second University of Naples, the authors compared the various therapy techniques of the conservative excisional type, using 5 different methods. METHODS: One hundred and fifty-seven women, all with lesions of the neck of the uterus of varying degrees of severity, underwent the treatment. Cytologic and colposcopical controls (follow-up) were carried out at intervals over a period of time. RESULTS: In 5 of the 95 patients (5.3%) who underwent surgical conisation, the presence of invading carcinoma was noted. Of the 19 women treated with diathermical loop, 3 cases of mature squamous metaplasia, 3 cases of CIN I, 8 cases of CIN II, and 4 cases of CIN III were observed. In the 32 patients treated with laser-therapy a complete recovery, equal to 100% was obtained although with slight margins of under-estimation and over-estimation; the same result was verified in the 3 patients treated with electroresection with high frequency radio waves and in the 8 patients treated with microneedle. CONCLUSIONS: On the basis of these results it is concluded that lasertherapy and electroresection with high frequency radio waves (3.8 MHz) using electrodes with "bands" or with "linears" (microneedle) gave the best results for both the therapeutical advantages with anatomical and functional integrity of the cervix and for economic reasons.

[Triptorelin therapy in uterine leiomyomatosis. Study of 18 cases]. / Terapia con triptorelina nella leiomiomatosi uterina. Studio di 18 casi.

BACKGROUND: The validity of tryptoreline treatment in uterine myomatosis is demonstrated, both as alternative therapy to surgery in patients in fertile age and as preoperative therapy reducing myomatosis volume. MATERIALS AND METHODS: In the outpatients department of Gynecologic and Obstetric Institute of the Second University of Naples, eighteen women, from 35 to 56 years old, with symptomatic uterine myomas, diagnosed by clinical examination and confirmed by pelvic ultrasonographic were treated with a delayed-release microcapsule preparation of D-Trp-6-LHRH (triptorelin) injected im, every 28 days. The duration of treatment was 6 months. RESULTS: The results are statistically significant for 16 patients that have completed the therapy with maximal reduction in uterine and leiomyomas volumes after 3 months of treatment. Minor side effects such as hot flushes, vaginal dryness, headache, dyspareunia were frequently encountered, but they disappeared progressively after the end of therapy. CONCLUSIONS: Four months after treatment, no significant increase in uterine and myoma volume, was noted.

[Early diagnosis of adenocarcinoma by endometrial cytologic samples]. / Diagnosi precoce dell'adenocarcinoma mediante prelievo citologico endometriale.

145 endometrial cytologic samples were taken by Endocyte and they were compared to histologic samples. The diagnostic concordance was 96.55%, proliferative endometrium, secretory endometrium, hyperplastic endometrium and carcinoma were screened and only 2.75% of cases were uncertain. Endometrial cytology is advantageous because Endocyte can be used in the out-clinic without risks for patients.

[Treatment of endometriosis with GnRH analogues]. / Trattamento dell'endometriosi con gli analoghi del GnRH.

BACKGROUND: Since a continuous administration of adequate doses of luteinizing hormone-releasing hormones (LHRH) or of an agonist leads to a hypogonadism-like condition, it is possible to use this effect for the treatment of endometriosis. The present study reports the results obtained in the Gynaecology and Obstetrics Institute of the Second University of Naples, with a long-acting formulation of a GnRH analogues (D-Trp6-LHRH) in biodegradable microcapsules, at monthly intervals. MATERIALS AND METHODS: The study was carried out on 40 women with endometriosis diagnosed by laparoscopy or laparotomy. The duration of treatment in patients in stage I-II was of 6 months, in patients in stage III or IV was of 9 months. RESULTS: After 12 months from the end of therapy, 27 patients did not show any sign of endometriosis with ultrasound and clinical examination; 13 patients still showing endometriosis were from III or IV stage. CONCLUSIONS: This long-acting formulation should offer a better approach for chronic treatment.

Electrophoretic analysis of normal and regenerating rat liver membrane proteins.

It is known that the cell surface of transformed cells shows a composition different from that of normal cells. Since the growth response is one of the parameters which appears to be altered, i.e. transformed cells continue to proliferate under such conditions in which normal cells do not, each alteration of the membrane connected with transformation could be involved in proliferation control mechanisms. Therefore such modifications could be expected to occur also in normal cells undergoing mitotic stimulations. Our work aimed to test whether this hypothesis is true also in the case of regenerating liver following partial hepatectomy. Electrophoresis was performed with polyacrylamide gel additioned with SDS in liver membranes from rats partially hepatectomized from 4h, 15h and 24h and solubilized with different detergents (solutions A, B and C). From the results we observed that liver membranes from 4h hepatectomized rats show a decrease in the amount of high molecular weight proteins; the appearance of two additional bands with molecular weight about 40,000 was also detected. At 15h after operation we observed a percent increase in the high molecular weight areas and a decrease in the low molecular weight one.

[Interference of some detergent micelles with the titration of protein]. / Interferenza di alcune miscele di detergenti con il dosaggio di proteine.

We have examined the possible interferences with spectrophotometric protein determination of some detergents commonly used for the solubilization of membrane proteins. The results show that some mixtures of Triton X100 with SDS or DOC, at given concentrations, interfere with BSA determination by the method of Lowry.

Direct demonstration of beta-globin mRNA in homozygous Ferrara betaO-thalassaemia patients.

In cases of betaO-thalassaemia from Ferrara, Italy, the beta-globin gene in transcribed into mRNA but no protein is synthesised. For these cases there is no hybridisation data suggesting a globin gene structural mutation. This again demonstrates the diverse molecular events which may cause this prevalent hereditary disease.