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Biomedical subjects

A Rizzo

Publications and source records attributed to A Rizzo.

At least 127 records · Page 7Linked to original sources

The use of dichloromethylene bisphosphonate and aminobutane bisphosphonate in hypercalcemia of malignancy.

54 patients with malignant hypercalcemia were treated with either dichloromethylene bisphosphonate (Cl2MBP) or aminobutane bisphosphonate (AHButBP). Both compounds infused intravenously (i.v.) were rapidly effective in lowering serum calcium to normal range and a potency ratio between Cl2MBP and AHButBP could be roughly estimated as 1:100-250. 600 mg of Cl2MBP infused in one day over 9 h in nine patients were only slightly less effective (serum calcium from 12.3 +/- 1.7 to 10.1 +/- 1.1 SE, mg/dl) than 3300 mg infused in 11 consecutive days (13.4 +/- 1.9 to 9.3 +/- 1.2 SE, mg/dl). Thus the effectiveness of treatment with Cl2MBP was related better to the overall time of infusion than to the cumulative dose administered. This could not be demonstrated in a similar trial using AHButBP. 1600 mg Cl2MBP daily p.o. was unable to prevent the relapse of hypercalcemia in four patients after a treatment course with i.v. bisphosphonates. 100 mg of Cl2MBP intramuscularly maintained serum calcium within the normal range in two out of eight patients; however, weekly infusions of either Cl2MBP or AHButBP prevented the relapse of hypercalcemia in eight similarly treated patients for several weeks. Providing that adequate dosages are adopted, parenteral Cl2MBP and AHButBP may be a useful measure for controlling hypercalcemia in patients with carcinoma.

Administration, Oral↗

Correction of pulmonary atresia with ventricular septal defect in the absence of the pulmonary trunk and the central pulmonary arteries (so-called truncus type IV).

A child with pulmonary atresia and ventricular septal defect and no extraparenchymal pulmonary arteries had all the bronchopulmonary arterial segments connected to naturally occurring systemic-pulmonary collaterals. A three-staged surgical correction was performed. At the first and second stages, the arteries of each hilus were interconnected with synthetic arteries. At the third stage, the ventricular septal defect was closed, and continuity between the right ventricle and the bilateral pulmonary circulation was established with a valved conduit giving rise to a side arm. Postoperative evolution was good, with acceptable postrepair per right ventricular--left ventricular pressure ratio.

Collateral Circulation↗

Alcohol intake and withdrawal: effects on branched chain amino acids and alanine.

The effects of chronic alcohol consumption on plasma branched chain amino acids and alanine concentrations were evaluated, and basal blood concentrations of these amino acids were determined after chronic ethanol intake and following a withdrawal period in 30 admitted alcoholics. After ethanol intake, alcoholics showed increased branched chain amino acid concentrations; the blood alanine concentrations were depressed after the withdrawal period. To evaluate the effect of ethanol on diurnal variations of these amino acids in the blood, a group of these patients underwent two isocaloric diets with and without wine. The diet with alcohol induced a sustained increase of branched chain amino acids persisting even after the postprandial phase with a decrease of alanine as compared to the diet without.

Adult↗

Early estimate of theophylline clearance during intravenous infusion.

We examined two rapid methods of measuring theophylline clearance using pairs of serum concentration measurements, and compared them with the steady-state values in 31 patients with acute asthma. A constant intravenous aminophylline infusion was started at a rate given by current guidelines. Theophylline clearance was estimated from two serum measurements made with an interval of at least 4 h, providing clearance estimates 5 h from commencement. Duplicate estimates were made, using either a 3rd serum measurement at 12 h or a 3rd and 4th at 7 and 14 h. A steady-state estimate was finally made after 48 h constant infusion. The two rapid estimates agreed well both between themselves and with the steady-state determination despite wide variations in the clinical status of the patients. These methods provide a rapid means of monitoring dosage in the individual patient. This is particularly important when the predicted dose is inappropriate.

Acute Disease↗

Neurologic signs in senescence.

We examined 2,029 volunteers 50 to 93 years of age in a cross-sectional study of nine bedside neurologic tests to determine the frequency of "abnormal" responses in uncomplicated aging (senescence). Rates of abnormal responses remained constant until age 70 years, after which they increased significantly. The number of abnormal signs per subject also increased, especially over 70 years of age. These results provide normative data against which these signs may be compared when applied as a clinical screening battery for diffuse cerebral dysfunction.

Aged↗

Role of the autonomic nervous system in the control of heart rate and blood pressure in the defence reaction in conscious dogs.

The present study was performed on conscious, chronically instrumented dogs, which underwent selective blockade of sympathetic adrenergic and vagal outflows. Excitements were performed on these animals in normal states (N), after chronic treatment with guanethidine, for sympathetic blockade (SB), after cold vagal blockade (VB), and after combined sympathetic and vagal blockade (SB + VB). Heart rate and arterial blood pressure were monitored in all the experiments, while a group of dogs was also tested with an electromagnetic flowmeter on the superior mesenteric artery. The role of the sympathetic and parasympathetic controls in the defence reaction was assumed from comparison of experiments performed in the presence or in the absence of each (or both) autonomic component(s). In the SB + VB condition, excitement was followed by sudden hypotension, without changes in heart rate. In VB experiments, a brief and transient hypotension appeared, followed by gradually developed hypertension, while heart rate progressively rose in about 5 s; there was no sudden increase in mesenteric vascular resistance, which contrasted with the very marked reaction in N experiments. Under vagal control alone (SB), the stimulus elicited prompt tachycardia and hypertension, followed by a period of moderately reduced blood pressure. We conclude that, while the defence reaction leads to a sudden fall of arterial blood pressure, in the absence of compensatory mechanisms, both branches of the autonomic nervous system play a protective role against hypotension. In addition, the modulation of the vagal outflow, leading to sudden changes in the heart performance, seems to be responsible for the initiation of the overall haemodynamic adjustments following excitements. The possibility that withdrawal of the parasympathetic outflow to the heart may raise arterial blood pressure was verified in a special experiment in which artificial vagal stimulation in a conscious (vagal blocked) dog, was turned off for brief periods, before and after guanethidine. This led to changes in blood pressure and heart rate very similar to those seen at the onset of the defence reaction, both in N and SB conditions.

Aggression↗

Ergometric evaluation of the effects of captopril in hypertensive patients with stable angina.

The antihypertensive and anti-ischaemic effects of methyldopa and captopril were compared in 12 hypertensive patients with coronary artery disease. The antihypertensive effect of alpha-methyldopa (A) and captopril (C) were significant and similar. On the other hand, while methyldopa did not increase the product of systolic pressure and heart rate and did decrease the effort-induced S-T segment depression, C increased the double product (DP) and decreased the ischaemic S-T changes. Captopril might be useful in the treatment of hypertensive patients with coronary artery disease.

Aged↗

[Electrophysiologic effects of propafenone in subjects with pre-existing excito-conduction disorders].

Few data are currently available regarding the electrophysiological effects of Propafenon administration in patients with pre-existing excito-conduction system disturbances. We have performed electrophysiological evaluation in 18 patients (15 males and 3 females, mean age 61 +/- 9 years - 4 patients with sinus bradycardia, 5 pts with AVN block, 4 patients with bundle branch block and normal HV and 5 patients with bundle branch block and prolonged HV) before and after intravenous administration of Propafenon (1 mg/Kg B.W. in 5 minutes). Propafenone administration decreased the heart rate, significantly lengthened AH and HV intervals, lengthened atrial, ventricular and, above all, AVN refractory periods. In no cases sinus pauses, marked bradycardia, spontaneous A-V block or additional intraventricular conduction disturbances were observed. We conclude that: due to its marked electrophysiological effects on AVN and His-Purkinje system, Propafenon is electively indicated for the treatment of ventricular arrhythmias and paroxysmal supraventricular tachycardia with AVN reentry; Propafenon intravenous administration appears to be safe also in pts with preexisting excitation and conduction disturbances.

Anti-Arrhythmia Agents↗

Analysis of dose-response curves in the detection of bronchial hyperreactivity.

In 12 reference subjects and 23 asthmatic patients under clinical and functional remission, dose-response curves following inhalation of nebulized carbachol solution were performed. Response was assessed both in terms of SRaw and SGaw and the best fitting mathematical function (linear, exponential, polynomial and logarithmic) was looked for. Discriminating power and day-to-day reproducibility were better when using SGaw, independently from the fitted model. For the sake of simplicity, therefore, the linear or exponential treatment of indices seem preferable.

Adult↗