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Biomedical subjects

A Grimaldi

Publications and source records attributed to A Grimaldi.

At least 181 records · Page 10Linked to original sources
PubMed1986

[Exploration of left ventricular function in insulin-dependent diabetics (relation with retinopathy)].

Non invasive methods for the exploration of myocardial function permit the demonstration of preclinical diabetic cardiomyopathy. In this study, we have tried to define the relationship between the degree of diabetic retinopathy and the presence of myocardial dysfunction. We have recorded echocardiogram and phonomechanograms on thirty two insulin dependent diabetics (IDD) less than 50 years of age, without evidence of arteriosclerosis. All patients had a normal baseline electrocardiogram and a normal bicycle exercise test. These diabetics were assigned to three groups: I = no retinopathy (9 patients); II = minimum retinopathy (12 patients); III = marked retinopathy (11 patients). They were compared to ten non-diabetic control subjects of similar age (group 0). None of the parameters of systolic function was modified in the different groups of diabetics in comparison with the control group. We found, however, a very significant reduction of the maximum rate of enlargement of left ventricule and reduction of the maximum narrowing rate of the left ventricular posterior wall during the protodiastolic period in group III, v.s. group 0, I and II. Group III contained 3 patients with borderline hypertension and 5 patients with diabetic glomerulopathy. Our results indicate a diminution of myocardial compliance and relaxation in those IDD with marked retinopathy, but it raises the question of the role of borderline elevations of arterial pressure or hypertension during physical exercise, which are frequently found in diabetics with retinopathy in causing these abnormalities.

Adolescent↗
PubMed1986

Alteration of chemotherapy (cisplatin and 5-FU) and radiotherapy in the management of advanced or recurrent head and neck cancer: a phase II study.

Between July '84 and July '85, 20 patients with very advanced or relapsing carcinomas of the upper aerodigestive tract were treated with polychemotherapy (cisplatin 20 mg/m2 days 1 to 5, and 5-fluorouracil 200 mg/m2 days 1 to 5, q. 3 weeks), alternated with radiation (3 split courses, 20 Gy each). Toxicity was moderate and in particular, mucositis and other relevant side effects including leukopenia, thrombocytopenia and nausea, were rare. Antitumoral activity consisted of nine complete responses and six partial responses (75% objective responses). Our conclusions are that cisplatin and 5-FU can be alternated with radiation with acceptable toxicity. The treatment has shown interesting antitumoral activity. Its role in cancer management must be investigated with controlled clinical trials.

Adult↗
PubMed1985

[Blood glucose and insulin secretion after meals rich in simple and complex carbohydrates, in non-insulin-dependent diabetics].

In 10 well controlled non insulin-dependent diabetics, 25 g of complex sugars were replaced by the same amount of simple sugars in each of two isocaloric meals identical in their lipid, protein and carbohydrate contents. This had no detrimental effect on postprandial glycaemic and insulin responses. There were no statistically significant changes in areas under the curve and kinetics of glycaemic, insulin and peptide C responses after ingestion of limited amounts of simple sugars. It appears from these results that well controlled, non insulin-dependent diabetic patients without marked postprandial fluctuations in glycaemia (as confirmed by self-performed capillary blood tests) can be authorized to take 25 to 40 g of simple sugars (preferably fructose) during meals.

Adult↗
PubMed1985

Failure of second-line therapy to modify survival in relapsed squamous cell carcinoma of the head and neck.

Between August 1979 and August 1984, 47 consecutive patients with recurrent squamous cell carcinoma of the head and neck entered one of three consecutive second-line treatments. Response rates with each treatment were very different (70% vs 5.9% vs 75%), but there was no statistical difference in actuarial survival (survival: 30% vs 29% vs 20%, respectively, at 260 days). In light of this observation, the efficacy of the second-line therapy appears doubtful and the survival of relapsing patients seems unrelated to the response achieved.

Adult↗
PubMed1985

Antidiuretic hormone response to volume depletion in diabetic patients with cardiac autonomic dysfunction.

Thirty-three insulin-dependent diabetic patients were separated into two groups from the results of three different tests for cardiac vagal neuropathy: heart rate response to deep breathing, Valsalva manoeuvre and heart rate response to postural change. Seventeen patients were considered as without ('intact' patients) and 16 as with ('denervated' patients) cardiac autonomic dysfunction. One patient with a transplanted heart was also studied. Plasma antidiuretic hormone (ADH), plasma aldosterone and plasma renin activity (PRA) were measured immediately before and 60 min after intravenous administration of frusemide and passage from lying to standing. The kinetics of hormonal responses were analysed more precisely (five blood collections) in six patients of each group who were studied again. Heart rate and blood pressure were recorded before each blood collection. Volume depletion estimated from the rise in plasma protein (+ 11.9 and + 12.2% in 'denervated' and 'intact' patients respectively) and heart rate response (+ 1.06 and + 14.7%) were similar in both groups. Mean blood pressure was unchanged in the 'intact' patients whereas it fell in the 'denervated' patients (-13.5%). PRA (+ 161.5 and + 231.2% in 'denervated' and 'intact' patients respectively) and plasma aldosterone (+ 318.2 and 279%) increased in both groups whereas plasma ADH was stimulated only in 'intact' patients (+ 55.3%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Changes in blood pressure and thermographic values resulting from use of a beta-blocker plus diuretic and of an alpha-beta-blocker plus diuretic.

Changes in arterial blood pressure and in thermographic values were evaluated in two groups of 15 hypertensive patients, each of which was treated, on a random basis, with a combination of atenolol plus chlorthalidone or a combination of labetalol plus chlorthalidone. Both combinations produced a statistically significant reduction in blood pressure values (p less than 0.01) with no changes in heart rate. Telethermographic investigations revealed the presence of hypothermia of the hands before treatment in all the hypertensive patients examined, but not in the control group (10 normal subjects with no vascular and/or hyperthermic disease). After one month of treatment, no changes in peripheral vascularization were observed in the group treated with atenolol plus chlorthalidone, except for 4 cases showing mild improvement, probably due to a reduction in peripheral resistance as a result of the treatment and to a consequent increase in blood flow in the area investigated. In the group treated with labetalol plus chlorthalidone, on the other hand, a substantial recovery of vascular flow was observed in 12 patients as a result of the treatment, while the remaining 3 patients showed a fair degree of improvement (2 degrees C). Both preparations lent themselves to simplified administration regimens with good patient compliance and no adverse reactions.

Adult↗
PubMed1985

Phase I-II trial with cisplatin and 5-FU in recurrent head and neck cancer: an effective outpatient schedule.

Thirty patients with squamous cell carcinoma of the head and neck were treated with a combination of cisplatin (20 mg/m2) and 5-FU (400-200 mg/m2) by iv push on Days 1-5 every 21 days. All patients but two had relapsed disease. Twenty-seven patients were evaluable for response: there were four complete responses and 12 partial responses (objective response rate, 59.2%). The response rate falls to 53.3% if it is calculated on the total number of patients entered. Twenty-seven patients were evaluable for toxicity: myelosuppression occurred in ten patients (37%), while renal toxicity, nausea and vomiting, and stomatitis were quite rare and moderate. These results look encouraging and suggest the need for further studies.

Adult↗