Amyotrophic lateral sclerosis: an epidemiological study in the Province of Messina, Italy, 1976-1985

An epidemiological investigation of 41 subjects with amyotrophic lateral sclerosis observed in the Province of Messina during 1976-1985 was performed. The incidence was 0.61/100,000 and the prevalence 2.48/100,000 inhabitants. The illness was found to be prevalent in males. The atrophic type occurred in 17 subjects, the bulbar type in 23 cases and the pseudo-polyneuritic form in only one patient. The mean age on the onset was 57.29 +/- 10.55 years. The duration of the illness was significantly higher in patients with atrophic type (p less than 0.01). No significant difference between occupation and development of the disease was found. Among all patients 12.19% presented evidence of trauma, but traumatic events were equally present in a control group.     

Tuberculous meningitis: A retrospective survey of 22 cases

Clinical and biological findings likely to constitute prognostic factors were analyzed in a retrospective survey of 22 cases of tuberculous meningitis. In particular, associations between clinical and biological findings (clinical grade on admission, normal and abnormal CSF protein and glucose values) and outcome of illness were sought. On admission 16 patients had altered consciousness, 11 hemiparesis and 7 sixth cranial nerve paresis. Meningeal signs were present in all subjects. 7 had a positive culture for Mycobacterium tuberculosis. 9 patients recovered completely, 7 had serious late sequelae, 6 died. Prognosis appeared to be correlated to neurological status at admission

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Sommario è stato effettuato uno studio retrospettivo su 22 casi di meningite tubercolare al fine di valutare i parametri clinico-biologici possibilmente implicati nella prognosi. Particolare attenzione è stata rivolta all'associazione tra quadro clinico al momento dell'osservazione, reperti liquorali (proteine, glucosio) ed evoluzione della malattia. Al momento del ricovero 16 pazienti presentavano alterazione della coscienza, 11 emiparesi, 7 paralisi del VI nervo cranico. In 7 è stata riscontrata positività liquorale per Mycobacterium Tuberculosis. Al momento dell'indagine 9 soggetti erano guariti completamente, 7 avevano esiti neurologici importanti, 6 erano deceduti. Correlazioni statisticamente significative sono state riscontrate tra obiettività neurologica all'ingresso ed esito di malattia.

     

Stereotactic endocavitary treatment of cysts and pseudocysts of glioma. Preliminary report

The present study reports the results of the stereotactic treatment via endocavitary irradiation (Talaraich's method) of 50 gliomatous cysts (volume: 5-242 cm3; av.: 73 cm3) in 45 patients (M: 24; F: 21; age 3.5-57 yrs; av.: 22 yrs) in the period January 1973-January 1987. Twenty-four patients (27 cysts) were affected by a grade I glioma, 10 patients (12 cysts) by a grade II and 11 patients (11 cysts) by a grade III or IV glioma. The first step in the treatment was a neuroradiological stereotactic stereoscopical survey (tele-angiography, ventriculography, cystography) with serial biopsies and a cystic impermeability test (injection of 0.3-1 mCi of Re 186). One week later one therapeutic dose, ranging between 5 and 85 mCi of a beta-emitting colloidal radioisotope (Re 186, Au 198, Y 90), was stereotactically injected into the cyst. The stereotactic treatment was not followed by severe side effects. In high grade gliomas (grade III and IV) the benefit of the possible shrinkage and/or disappearance of the cyst was vanished by the solid tumor progression. In low grade gliomas (grade I and II) more than 50% of the cysts disappeared and 25% of them shrinked up to one third of the starting volume (follow-up: 5-168 mo.; av.: 54 mo.). At present almost only Re 186 is employed using a cyst wall dose of 400-500 Gys. The low surgical invasiveness, the absence of severe side effects and good therapeutical results induce us to propose this as a first choice treatment in inoperable low grade gliomatous expanding cysts.     

Headache in acromegaly: dramatic improvement with the somatostatin analogue SMS 201-995

Two acromegalic patients with severe headache, persisting after pituitary adenomectomy followed by radiotherapy in one, were treated with the somatostatin analogue SMS 201-995. Both had been resistant to conventional headache therapy and experienced dramatic and rapid relief after the first injection of the analogue. This result persisted with long-term treatment of the drug. Although the mechanism of action of SMS 201-995 in pain remains unclear, the rapid and efficacious analgesic effect of this compound may be one more indication for its use in pituitary tumors associated with cephalalgias.     

Outcomes of oesophageal atresia and tracheo‐oesophageal fistula repair

Oesophageal atresia and tracheo‐oesophageal fistula are congenital anomalies of the oesophagus requiring surgical repair in infancy, either by open or thoracoscopic approach. Although mortality rates associated with this procedure are low, children may go on to have complications throughout childhood and into adulthood, most commonly related to ongoing gastrointestinal and respiratory symptoms. This review outlines the early, mid and long‐term outcomes for these children in terms of quality of life and incidence of symptoms.     

Oncolytic Viruses and Hematological Malignancies: A New Class of Immunotherapy Drugs

The use of viruses for tumour treatment has been imagined more than one hundred years ago, when it was reported that viral diseases were occasionally leading to a decrease in neoplastic lesions. Oncolytic viruses (OVs) seem to have a specific tropism for tumour cells. Previously, it was hypothesised that OVs’ antineoplastic actions were mainly due to their ability to contaminate, proliferate and destroy tumour cells and the immediate destructive effect on cells was believed to be the single mechanism of action of OVs’ action. Instead, it has been established that oncolytic viruses operate via a multiplicity of systems, including mutation of tumour milieu and a composite change of the activity of immune effectors. Oncolytic viruses redesign the tumour environment towards an antitumour milieu. The aim of our work is to evaluate the findings present in the literature about the use of OVs in the cure of haematological neoplastic pathologies such as multiple myeloma, acute and chronic myeloid leukaemia, and lymphoproliferative diseases. Further experimentations are essential to recognize the most efficient virus or treatment combinations for specific haematological diseases, and the combinations able to induce the strongest immune response.