Minerva medica
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Cellular immunity has been studied in 92 patients with solid tumors undergoing surgery, in order to evaluate immunocompetence at the time of diagnosis and to assess the prognostic value of parameters of cellular immunity. The results show that total lymphocyte counts, T-lymphocyte counts and lymphocyte blastogenic responses are moderately depressed at diagnosis in the cancer patients as compared to age matched controls. These parameters of cell mediated immunity "in vitro" seem to be of limited prognostic value, since no correlation was found with the clinical course during the first 6 postoperative months. Depression of delayed hypersensitivity response to cutaneous antigens appeared to be an index of poor prognosis.
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Surgical and pharmacological management of cancer pain is described and discussed according to the physiopathological mechanisms underlying this complex syndrome. The therapeutic approach is planned in three mayor phases which may be employed alone or in combination, following an accurate evaluation of the pathophysiology and the clinical pattern in every single patient. The first phase includes multifocal pharmacological therapy by nonnarcotic drugs in order to affect at different levels the physiopathological mechanisms of cancer pain. ⋯ The pharmacological treatment must be continued and associated to surgery. The third phase includes hypophysectomy, deep brain stimulation, psychosurgery and/or narcotic drug therapy, which are the last step in management of terminal cancer pain when all treatments have been ineffective. The results of this therapeutic program in 188 patients affected by pain of malignant origin are reported and discussed.
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The Authors deal with some clinical aspect of the commonest types of respiratory tract viral infections. After a description of the characteristics of the most important diseases (common cold, ARD, influenza, viral pneumonia) they deal with some particular problem difficult in resolution, both from a pathogenetic and clinical viewpoint and quite constant bacterial over infection, the cardiac complications, th possible evolution to fibrosis and the relationship between viral infections and asthma. The nowadays problem of immunological and chemotherapeutic prevention of viral infections, particularly of type A influenza, is also discussed.
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The authors, after having reviewed folic acid and folates chemical and biochemical characteristics and their absorption and excretion modalities, determine serum folate levels by radioassay method on 30 patients with renal failure in chronic dialysis and on 24 normal controls. Low serum folate levels concerned 14 uremic patients (46.6% of th cases): 10 in hemodialysis and 4 in peritoneal dialysis. The mean serum folate values was 3.31 ng/ml (+/- 1.93) for the uremic patients' group and 4.29 ng/ml (+/- 1.21) for the control group. ⋯ No significant difference was observed among the mean serum folate levels of the uremic patients in peritoneal dialysis and of those in hemodialysis. Significantly low serum folate levels were finally found for the uremic HBsAg-positive patients, but in the same subjects the dialytic treatment period had been very prolonged. The authors conclude emphasizing the usefulness of folic acid treatment in uremic patients on dialysis, also without having an evident hematologic picture of megaloblastic anemia.