RESUMO
BACKGROUND: Trastuzumab has been recently proposed as a treatment for patients with HER2-positive advanced/metastatic gastric cancer (GC). Since most patients have inoperable disease at diagnosis, accurate assessment of HER2 status on biopsy specimens is essential to select the patients who may benefit from therapy. AIM: The aim of this study is to establish whether HER2 status assessed on biopsy material could be reliable for treatment decisions using anti-HER2 agents. METHODS: The HER2 status was evaluated in 61 consecutive pairs of biopsy and surgical GCs samples by immunohistochemistry and chromogenic in situ hybridization. RESULTS: The overall concordance of HER2 status between biopsy and surgical specimens was 91.8 % with a predictive positive value of 71.4 % and a negative predictive value of 94.4 %. Of five discordant cases, there were three negative and two positive false biopsy results. All the false negative cases showed heterogeneous expression of HER2 protein in surgical samples. Two cases displayed overexpression of the receptors without corresponding gene amplification. CONCLUSIONS: HER2 status as evaluated on biopsy samples is a fairly good predictor of HER2 status of surgically-excised GCs. The most important influence for discordant results is tumor heterogeneity. However, HER2 overexpression, especially without coexisting gene amplification, may only be a temporary change in a tumor population. This may explain those cases with positive HER2 evaluation on biopsy material and a negative result on corresponding surgical specimen.
Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Biópsia/métodos , Receptor ErbB-2/metabolismo , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Biópsia/normas , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Amplificação de Genes , Humanos , Imuno-Histoquímica/métodos , Imuno-Histoquímica/normas , Hibridização In Situ/métodos , Hibridização In Situ/normas , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Receptor ErbB-2/genética , Reprodutibilidade dos Testes , Neoplasias Gástricas/cirurgia , TrastuzumabRESUMO
To clarify the biological role of the 90K/Mac-2BP glycoprotein, we evaluated the ability of two MAbs SP-2 and 1A4.22, to reveal this glycoprotein in both serum and tissue from hepatocellular carcinoma (HCC) patients. Tissue expression of 90K was detected by the immunohistochemical method in 20 HCC patients, while the 90K serum level was assessed by the ELISA assay in 13 HCC patients. MAb SP-2 was reactive only in serum, with a mean value of 12.8+/- 6.7 microg/ml . On the contrary, MAb 1A4.22 revealed immunoreactivity both in 92% of sera and in 60% of neoplastic samples. Positive staining was seen only in the epithelial cells and was cytoplasmic and granular in all instances. The mean 90K serum level assayed with MAb 1A4.22 was 29.4 +/- 13.7 microg/ml. Patients with a 90K serum level
Assuntos
Anticorpos Monoclonais , Especificidade de Anticorpos , Antígenos de Neoplasias/análise , Antígenos de Neoplasias/imunologia , Carcinoma Hepatocelular/imunologia , Células Epiteliais/imunologia , Glicoproteínas de Membrana/análise , Glicoproteínas de Membrana/imunologia , Idoso , Anticorpos Monoclonais/química , Antígenos de Neoplasias/sangue , Carcinoma Hepatocelular/patologia , Ensaio de Imunoadsorção Enzimática , Células Epiteliais/patologia , Feminino , Humanos , Imuno-Histoquímica/métodos , Masculino , Glicoproteínas de Membrana/sangue , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
In spite of the widespread use of cytological smears for diagnosis of breast cancer lesions, many surgeons are still reluctant to accept the cytological report as the only criterion for performing definitive surgery. Modern surgical strategy requires a preoperative planning of the surgical treatment, possible through the use of core biopsy, which provides a diagnosis based on tissue specimens, thus permitting the study of both the architectural and cytological patterns. The authors report their five-year experience with this technique and evaluate its diagnostic usefulness and ability to reduce intraoperative biopsy procedures. The histological examination of 92 palpable breast lesions, clinically and mammographically detected, was performed with core biopsy, and diagnosis was confirmed with the surgical sample in 80 cases. A definitive histological diagnosis was obtained with core biopsy in 90% of cases. Only nine cases required confirmation with frozen section diagnosis at the time of definitive surgery. The sensibility of core biopsy was 92%, specificity and predictive value of positive result were 100%, and diagnostic efficiency was 86%. This study confirms the usefulness of systematic use of core biopsy for definitive preoperative diagnosis of breast cancer; the simplicity, safety and low cost of this method also make ultrasound-guided core biopsy applicable to nonpalpable lesions.
RESUMO
The early monoclonal antibodies (MAbs) to p53 are considered reliable only on frozen sections. We examined the immunohistochemical expression of p53 in 40 paraffin-embedded samples obtained from colon carcinomas using the two new MAbs DO-1 and DO-7. Thirty-one frozen samples were obtained from the same surgical specimens and were stained using MAb PAb 1801 which has a high specificity to p53. Fifty-five percent of 40 paraffin-embedded samples was positively stained with both MAbs DO series and showed a 100% concordance rate while 52% of 31 frozen samples was positively stained with MAb PAb 1801. The concordance rate between the reactivity of MAbs DO series and that of MAb PAb 1801 was 98%. Therefore, the reactivity of MAbs DO Series in paraffin-embedded material is similar and reflects accurately the overexpression of p53 when compared with the reactivity of MAb PAb 1801. Further investigations, moreover, can be performed using the MAbs DO series on archival material for a full understanding of the p53 involvement in human cancer.
RESUMO
Till now the immunohistochemical studies on the procathepsin D expression in breast cancer have been performed using polyclonal antibodies on paraffin-embedded sections because the monoclonal ones were considered effective only on frozen sections. In this study we compared the MAb M1G8 reactivity, which recognizes the 52 Kd procathepsin D, on a series of frozen and paraffin-embedded sections of the same specimen from 22 breast cancers, using the immunohistochemical method. This methodological choice was due to the necessity to perform further studies with monoclonal antibodies using archival material to clarify the procathepsin D prognostic role. MAb M1G8 was clearly positive with a 100% concordance rate both in frozen and paraffin sections of the same specimen.
RESUMO
Fifty patients with breast cancer were studied to examine the relationship between the immunohistochemical tumour expression of pS2 and 52 kilodalton-cathepsin D (52K-CD) proteins and several biological and clinical parameters. Our aim was to verify whether these two proteins may provide additional information for the management of breast cancer patients. By using a cut-off point of 10% for pS2 and 15% for 52K-CD valuations, we found that 24 of 50 (48%) carcinomas were pS2+ and 26 of 50 (52%) were 52K-CD+. A statistically significant positive association was found between pS2 positivity and ER presence (p=0.05), though 36% of ER-patients were pS2+. We did not find any correlation between the 52K-CD expression and other parameters studied, neither pS2. Although our findings confirm previous data correlating significantly the ER presence with pS2+ cases, we emphasise the necessity to standardize the use of a clinically significant cut-off point in further immunohistochemical studies to evaluate this protein and, therefore, to explain its role also in tumours lacking ER. As regard the 52K-CD, our results agree with those of other studies, though the association of this enzyme with ER status is controversial in both cytosol and immunohistochemical studies, the use of monoclonal antibodies on frozen sections and polyclonal antibodies on paraffin section can explain this controversy. Our experience indicate the use of an immunohistochemical method in detection of this enzyme and the use of M1G8 (morioclonal antibody) on paraffin sections to make clear the possible role of 52K-CD in breast cancer.
RESUMO
It has been suggested that cathepsin D expression in stromal cells affects the prognosis of breast cancer. With reference to colon and breast cancer, this study verified cathepsin D immunostaining in epithelial and stromal cells of primary tumours and lymph-node metastases from 46 colorectal carcinomas. Eight of 46 cases (17%) were cathepsin D+ both in cancer and stromal cells. No staining was found either in cancer or stromal cells of the remaining cases. The results presented here suggest the possible paracrine influence of another diffusible factor produced by cancer cells which stimulates cathepsin D production in stromal and cancer cells.
Assuntos
Catepsina D/análise , Neoplasias Colorretais/enzimologia , Idoso , Animais , Neoplasias da Mama/enzimologia , Epitélio/enzimologia , Feminino , Humanos , Imuno-Histoquímica , Linfonodos/enzimologia , Metástase Linfática , Masculino , Camundongos , Células Estromais/enzimologiaRESUMO
The most studied mechanism of malignant transformation has been cell proliferation. The relationship between programmed cell death (apoptosis), cell proliferation, and apoptosis regulatory genes (p53 and bcl-2), was studied in normal colonic epithelium, 26 sporadic adenomas both early and late, 25 FAP adenomas, and 34 carcinomas. We showed a decrease in programmed cell death and an increase in cell proliferation during the transition from adenoma to carcinoma. The increase of expression of p53 from early (10%) to late adenomas (87%) contrasted with the decrease of bcl-2 staining. Sixty-two per cent and 23% of carcinomas were reactive for p53 and bcl-2 respectively. Abnormal early activation of the bcl-2 gene, rather than late p53 gene mutation appears to be responsible for inhibition of apoptosis in colorectal carcinogenesis. bcl-2 was higher in FAP adenomas than in sporadic cases, and in carcinomas favouring the accumulation of long-living cells, which are more subject to mutation and thus cancerization.
Assuntos
Apoptose , Neoplasias Colorretais/patologia , Neoplasias Colorretais/genética , Neoplasias Colorretais/metabolismo , Humanos , Imuno-Histoquímica , Mutação , Antígeno Nuclear de Célula em Proliferação/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Proteína Supressora de Tumor p53/genética , Proteína Supressora de Tumor p53/metabolismoRESUMO
OBJECTIVE: The polymerase chain reaction (PCR) has been extensively and successfully used to detect Helicobacter pylori in gastric juice and gastric biopsies. In contrast, the results obtained using faeces as biological samples for PCR are rather conflicting. This may be due to the presence of faecal inhibitory compounds (polysaccharides) which can inhibit the amplification reaction. The aim of this study was to characterize the H. pylori genotype in faecal samples by using specific primers for the cagA gene. To overcome the problem of contamination by polysaccharides, we used a filter-based extraction technique already applied in a previous study. METHODS: Antral and body biopsies were obtained from 30 symptomatic patients undergoing upper endoscopy. PCR was used to detect the presence of H. pylori organisms in faecal samples by using primers selected for the urease gene A. In addition, H. pylori organisms were characterized both in faecal samples and paraffin-embedded biopsies by PCR with specific primers for the cagA gene. RESULTS: All patients showed a positive CLO test (rapid urease test) and evidence of H. pylori by Warthin-Starry stain. PCR detected the urease A gene in the faecal samples of all patients. The cagA gene was detected in the faecal and biopsy samples of 18 subjects (60%). Duodenal ulcer and/or antral erosions were observed in 15 of the 18 cagA-positive patients (83.3%) and in five of the 12 cagA-negative patients (41.7%). Endoscopic features of normal mucosa or gastritis were observed in three cagA-positive patients (16.7%) and in seven cagA-negative patients (56.3%). cagA-positive status was found to be significantly related to the endoscopic features of duodenal ulceration and/or antral erosions. CONCLUSIONS: Our findings prove that faeces are suitable samples for the detection of cagA status. Moreover, they confirm the existence of a significant relationship between cagA-positive status and duodenal ulcer and/or antral erosions.
Assuntos
Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Fezes/microbiologia , Helicobacter pylori/genética , Adulto , Idoso , Corantes , Primers do DNA , Úlcera Duodenal/microbiologia , Úlcera Duodenal/patologia , Feminino , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Gastrite/microbiologia , Gastrite/patologia , Gastroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polissacarídeos Bacterianos/química , Antro Pilórico/microbiologia , Antro Pilórico/patologia , Estômago/microbiologia , Estômago/patologia , Urease/genéticaRESUMO
UNLABELLED: After strenuous physical exercise, many subjects show a significant bronchoconstriction and report dyspnea. Despite this clinical condition being a commonly encountered situation during daily life, which may be responsible for substantial disability there is little information on the relationship between the perception of dyspnea and exercise-induced bronchoconstriction (EIB) after a standardized exercise challenge. For these reasons, we evaluated 200 consecutive outpatients (median age 13 years, ranging from 5 to 56 years) referred to our laboratory to perform an exercise test out of suspicion of EIB. On exercise challenge, perception of dyspnea was rated on a modified bipolar Borg scale immediately before each FEV1 measurement. Sixty-nine (35%) subjects had a positive exercise challenge, defined as a decrease of at least 20% in FEV1 from baseline. Both the onset and the decay of dyspnea preceded those of bronchoconstriction. Overall, the rating of dyspnea in the laboratory was well related with the reports of exercise-related symptoms. Similarly, 36 of 77 (47%) asthmatics with a history of exertional symptoms and 24 of 65 patients (40%) without a history had a positive challenge. Asthmatics reporting exertional symptoms perceived a greater magnitude of dyspnea after exercise independently from the degree of bronchoconstriction. Overall, dyspnea was significantly but loosely correlated to the magnitude of decrease in FEV1, being also influenced by age, gender and BMI. CONCLUSIONS: We conclude that dyspnea recorded in the laboratory after exercise test is related to exertional symptoms reported during real life, but not completely related to EIB. The rating of dyspnea is a well-suited model to study naturally occurring exercise-induced dyspnea and a useful tool to enlarge the results of an exercise challenge.
Assuntos
Broncoconstrição/fisiologia , Dispneia/etiologia , Exercício Físico/fisiologia , Adolescente , Adulto , Criança , Pré-Escolar , Dispneia/fisiopatologia , Feminino , Volume Expiratório Forçado/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Lomefloxacin is a difluorinated quinolone with excellent activity against a wide range of pathogens including those responsible for acute exacerbations of chronic bronchitis (AECB). This open, cross-sectional, multicenter study has evaluated the efficacy and safety of a once-daily dosage of 400 mg lomefloxacin in patients with AECB chronically treated with theophylline. 137 patients (96 males, 41 females; mean age 66.1+/-11.2 yrs) were enrolled and 133 completed the study. 81% suffered from moderate AECB, 16% severe AECB. The clinical success rate was very high (95%), as well as the microbiological (93%). Side effects were scarce and were significant only in 3 patients, with 2 dropouts. All patients were using theophylline derivatives twice daily and continued without any variation in dosage during the lomefloxacin treatment. Theophylline plasma levels determined in 103 patients at baseline, during and at the end of the lomefloxacin treatment did not significantly change. We conclude that orally administered lomefloxacin at standard recommended dosage is well tolerated and effective in elderly patients with AECB. No dose adjustment is required even when it is co-administered with methylxanthines.
Assuntos
Anti-Infecciosos/uso terapêutico , Bronquite/tratamento farmacológico , Fluoroquinolonas , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Quinolonas/uso terapêutico , Teofilina/uso terapêutico , Doença Aguda , Administração Oral , Adulto , Idoso , Anti-Infecciosos/efeitos adversos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Quinolonas/efeitos adversosRESUMO
During the past few years it has become apparent that simultaneous resistance of tumour cells to a number of heterocyclic drugs (multidrug resistance) is often correlated with overexpression of a P-glycoprotein (P-gp or P-170). P-gp expression can be studied by molecular biology and immunohistochemical techniques. The latter provide a rapid, sensitive and specific screening method suitable for testing even a relatively small number of tumour cells like those obtained at biopsy. The aim of this study was to detect and localize the immunohistochemical expression of P-gp in normal and neoplastic gastrointestinal tissue using the Mab JSB-1 in formalin-fixed paraffin-embedded specimens. A particularly striking finding of our study was the consistent, prevalent higher expression of P-gp in the stomach than in the colon, with a higher percentage of immunostaining in normal than in neoplastic tissue. This is in agreement with the fact that not only is the prognosis known to be worse for stomach cancer, but also the response to treatment is lower. Further studies should be carried out to verify the possibility of making routine tests of this kind for the evaluation of multidrug resistance, to guide the selection of patients for treatment of cancer with chemotherapeutic drugs.
Assuntos
Membro 1 da Subfamília B de Cassetes de Ligação de ATP/análise , Neoplasias Colorretais/química , Mucosa Gástrica/química , Neoplasias Gástricas/química , Adulto , Distribuição por Idade , Idoso , Feminino , Formaldeído , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Parafina , Distribuição por Sexo , Inclusão do TecidoRESUMO
The aims of this study were to evaluate the prevalence of hepatitis delta virus (HDV) infection and risk factors associated to it. Three hundred sixty-one HBsAg chronic carriers from southern Italy were studied and 13.8% of them resulted anti-delta positive. 80% of these subjects were less than 50 years old. When anti-delta positive subjects were compared with anti-delta negative ones, a lower number of healthy HDV carriers and a higher frequency of cirrhotics were noted among anti-delta positive. Of lower than 50 years, imprisonment, sexual contacts with drug abusers and male homosexuality were risk factors of HDV infection. No association was found with sex, household contacts with HBV or HDV carriers, number of family members and transfusion of blood products. These data confirm the high prevalence of HDV infection in southern Italy.
Assuntos
Hepatite D/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Portador Sadio/epidemiologia , Portador Sadio/transmissão , Criança , Pré-Escolar , Feminino , Hepatite D/transmissão , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Distribuição por SexoRESUMO
A 28 year woman complained for a sudden abdominal pain with some of the classical signs of the acute abdomen. Since a bilateral ovarian mass was found at ultrasound examination, clinician decided that patient underwent a urgent surgery. At histology, this mass resulted to be a bilateral triphillic mature teratoma. A focus lined by endometrioid epithelium and embedded in the modified stroma of endometrial type, was found beyond the residual cortex of the left ovary. There was some fibrotic tissue separating the endometrial and teratomatous lesions. To our knowledge, these two diseases have never been reported as associated in literature, but this association has a clinical relevance because an endometriotic pathology can reveal a silent teratoma with bilateral ovarian localization.
Assuntos
Endometriose/complicações , Leiomioma/complicações , Neoplasias Ovarianas/complicações , Teratoma/complicações , Neoplasias Uterinas/complicações , Adulto , Endometriose/cirurgia , Feminino , Humanos , Leiomioma/cirurgia , Cistos Ovarianos/complicações , Cistos Ovarianos/patologia , Cistos Ovarianos/cirurgia , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/cirurgia , Ovariectomia , Teratoma/diagnóstico por imagem , Teratoma/cirurgia , Ultrassonografia , Neoplasias Uterinas/cirurgiaRESUMO
BACKGROUND: In spite of the widespread use of cytological smears for the diagnosis of breast cancer lesions, many surgeons are still reluctant to accept the cytological report as the only criterion for performing definitive surgery. Modern surgical strategy requires a preoperative planning of the surgical treatment which is possible with the use of core biopsy (CB) or FNB (fine needle biopsy) for the diagnosis of tissue specimens. METHODS: The authors report their five-year experience with this technique and evaluate its diagnostic usefulness and substitution of interoperative biopsy. The histological examination of 92 palpable breast lesions, clinically and mammographically detected, was performed with CB, and diagnosis was confirmed with the surgical sample in 80 cases. RESULTS: A definitive histological diagnosis was obtained with CB in 90% of cases. Only nine cases required confirmation with frozen section diagnosis at the time of definitive surgery. The sensibility of CB was 93%, specificity and predictive value of a positive result were 100%, and diagnostic efficiency was 95%. CONCLUSIONS: This study confirms the usefulness of the systematic use of CB for accurate preoperative diagnosis of breast cancer, and the simplicity, safety and accuracy of this method also make ultrasound-guided CB applicable to non-palpable lesions.
Assuntos
Neoplasias da Mama Masculina/patologia , Neoplasias da Mama/patologia , Mama/patologia , Cuidados Pré-Operatórios , Adulto , Idoso , Biópsia por Agulha/métodos , Neoplasias da Mama/cirurgia , Neoplasias da Mama Masculina/cirurgia , Feminino , Humanos , Masculino , Mastectomia/métodos , Pessoa de Meia-Idade , Sensibilidade e EspecificidadeRESUMO
We conducted a multicentre, double-blind, parallel group study to compare the clinical efficacy of a new antitussive drug, moguisteine (100 mg t.i.d.), to that of a reference standard, codeine (15 and 30 mg, t.i.d.). Both drugs were given orally for a period of two days. A group of 119 patients (mean age 54 yrs; 61 females and 58 males) with chronic, dry or slightly productive cough, associated with various respiratory disorders (including chronic obstructive pulmonary disease, respiratory malignancies and pulmonary fibrosis) were enrolled at six participating centres. The percentage reduction in the number of morning coughs over a period of 6 h after the first administered dose compared to baseline assessment, was 21% with moguisteine (n = 39), 28% with codeine 15 mg (n = 38), and 29% with codeine 30 mg (n = 36). Differences between treatments were not significant. The percentage reduction in the number of nocturnal coughs per hour, after the last evening dose compared to baseline assessment, was 33, 46 and 52%, respectively. Subjective assessments (patients' visual analogue scale scores of cough frequency, cough intensity and sleep disturbance, and investigators' ranking of cough severity) indicated that there was a similar improvement in cough symptoms in all treatment groups. Adverse events were observed in two patients on moguisteine, three on codeine 15 mg, and five on codeine 30 mg. No event was serious, but discontinuation of treatment was required in two patients on codeine 30 mg. The results of our study suggest that moguisteine 100 mg t.i.d. is safe, and seems to have an antitussive activity similar to that of codeine 15-30 mg t.i.d.
Assuntos
Antitussígenos/uso terapêutico , Codeína/uso terapêutico , Tosse/tratamento farmacológico , Tiazóis/uso terapêutico , Administração Oral , Adolescente , Adulto , Idoso , Antitussígenos/administração & dosagem , Antitussígenos/efeitos adversos , Doença Crônica , Ritmo Circadiano , Codeína/administração & dosagem , Codeína/efeitos adversos , Tosse/etiologia , Método Duplo-Cego , Feminino , Humanos , Pneumopatias Obstrutivas/complicações , Neoplasias Pulmonares/complicações , Masculino , Pessoa de Meia-Idade , Fibrose Pulmonar/complicações , Segurança , Tiazóis/administração & dosagem , Tiazóis/efeitos adversos , TiazolidinasRESUMO
The GENEBU Project is an open, observational survey evaluating home nebulizer practices in Italy. It consecutively included patients who were referred to one of the 27 participating chest clinics from May to December 1999 and who had been using a home nebulizer in the previous six months. The information source was a self-administered questionnaire compiled by the enrolled subjects. We collected 1257 questionnaires. The nebulizer equipment was heterogeneous, with at least 92 different models. Jet nebulizers were 90% of the total; 53% of these had a glass reservoir. Almost 80% of the patients selected the nebulizer themselves without any medical advice. In addition, most patients (> 80%) did not receive information on both the interface system and the optimal fill volume of the nebulizer. Corticosteroid nebulisation was widespread (74%), for both occasional and regular daily use, for both acute and chronic diseases from upper to lower airways. Beta 2-agonist (55%), anticholinergic (37%), mucolytic (32%) drugs were also often nebulised. More than 90% of patients mixed some active drugs. We conclude that the nebulizer equipment for home aerosol therapy was very heterogeneous and, probably, not always utilised at its best in Italy. The mixing of drugs and the widespread use of corticosteroids were peculiarities of home nebulizer therapy in Italy.
Assuntos
Nebulizadores e Vaporizadores , Agonistas Adrenérgicos beta/uso terapêutico , Antibacterianos/uso terapêutico , Estudos Transversais , Uso de Medicamentos , Desenho de Equipamento , Expectorantes/uso terapêutico , Glucocorticoides/uso terapêutico , Humanos , Itália , Nebulizadores e Vaporizadores/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
Fourteen out-patients with chronic bronchitis (n = 5) or chronic bronchial asthma (n = 9) entered a trial devised to evaluate the effect of the combined inhalation by pressurized aerosol of fenoterol 200 micrograms + ipratropium bromide 80 micrograms three times daily in a 12-week period of treatment. On the basis of the ventilatory and clinical findings, effective bronchodilatation with clinical improvement after drug inhalation was noticed throughout the whole observation time. In detail, the behaviour either of the FEV1 values at the control days or of the daily self-monitored peak expiratory flow (PEF) data showed a constant, statistically significant increase in the post-bronchodilator values with a prompt, long-lasting and persistent effect over the 3-month period; self-monitored PEF rates were particularly consistent with this result. No side-effects were seen in any cases, including the 5 patients who needed extra use of inhalers. The findings of the trial suggest that the combined inhalation of fenoterol and ipratropium bromide may play an important role in long-term therapy of many patients with chronic bronchitis or chronic bronchial asthma.
Assuntos
Derivados da Atropina/uso terapêutico , Fenoterol/uso terapêutico , Ipratrópio/uso terapêutico , Pneumopatias Obstrutivas/tratamento farmacológico , Administração por Inalação , Adulto , Asma/tratamento farmacológico , Bronquite/tratamento farmacológico , Feminino , Volume Expiratório Forçado , Humanos , Pneumopatias Obstrutivas/fisiopatologia , Masculino , Pessoa de Meia-Idade , Pico do Fluxo Expiratório , Fatores de TempoRESUMO
The prognostic and biological meaning of the association of colonic cancer with hyperplastic polyps (HP) is not as well known as that with adenomatous polyps (AP). In order to gain some insights into this matter, we have retrospectively studied two hundred and twelve patients with colon-rectal carcinoma in which 64 (30.18%) had synchronous AP, 24 (11.32%) had synchronous HP, 13 (6.13%) had both AP and HP and 111 had no synchronous polyps (52.36%). The 34 cases of synchronous HP, whether or not associated with AP, were located in the same colonic segments of the cancer and were found usually in the sigmoid-rectum. The AP were found throughout the colon-rectum with a similar rate of association with the cancer in each segment. The cancer associated with HP have a higher prevalence in the better prognostic stages of both Dukes and Jass-Morson systems. Conversely both AP and AP+HP associated cancers exhibit prevalences rates higher in the worst prognostic stages. Our observations suggest that separate factors might promote the growth of HP and AP and that a relationship between colonic cancer and synchronous HP might exist and differ from that demonstrated for AP and colonic cancer.