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Biomedical subjects

C Bianchini

Publications and source records attributed to C Bianchini.

At least 19 recordsLinked to original sources

Blood binding of selezen (imidazole salicylate) in man.

The interactions of selezen (imidazole salicylate) with human blood components were studied by equilibrium dialysis. These interactions were limited to the binding of salicylate to human serum albumin (HSA). The binding was saturable and involved several classes of binding sites with different association constants. A competition study indicated that salicylic acid at high concentration was able to displace warfarin and digitoxin but not glibenclamide from their HSA sites. On the other hand, selezen serum binding was decreased in renal impaired patients and this result was probably linked to the decreases in HSA concentration. So the use of small dosage regimens of selezen to these patients can be proposed. The same recommendation may be done for cirrhotic patients, where the decrease of selezen binding percentage was observed and due to both hypoalbuminemia and hyperbilirubinemia.

Anti-Inflammatory Agents, Non-Steroidal

Verapamil 240 SR versus verapamil 120 SR in arterial hypertension. A randomized double-blind, placebo-controlled study with 24-hour ambulatory blood pressure monitoring.

Fifteen patients (6 males, 9 females), age range 36-70 years, were enrolled in a randomized, double-blind, placebo-controlled study according to a Latin-square design, with the aim of comparing 24-hour blood pressure profiles after three 15-day treatment periods with placebo, verapamil SR 120 mg (V120 SR) given twice daily (bid), and verapamil SR 240 mg (V240 SR) given once daily (od). All of the patients were diagnosed as mild or moderate essential hypertensives on the basis of standard casual recordings. Noninvasive 24-hour ambulatory blood pressure (BP) monitoring was performed with an ICR Spacelab 5200 automatic device. In comparison with placebo, a clinically and statistically significant reduction in both systolic and diastolic BP over 24 hours was obtained with both active treatments. Comparison of the two active treatments shows that V240 SR led to a greater reduction in systolic and diastolic BP than V120 SR. No changes in heart rate were observed. Both treatments were well tolerated. In conclusion, both verapamil regimens proved to be effective and safe in treating essential hypertensives, with V240 SR giving better 24-hour BP control.

Adult

Calcium-channel blockade (nitrendipine) in combination with ACE inhibition (captopril) in the treatment of mild to moderate hypertension.

The antihypertensive efficacy of a combination of calcium-channel blockers and angiotensin-converting-enzyme (ACE) inhibitors in severe primary hypertension is well known, but a synergistic action of this drug combination in mild to moderate primary hypertension is still not established. Therefore, the aim of the present study was to evaluate the efficacy and tolerability of monotherapy with nitrendipine (20 mg) or captopril (100 mg), and of their combination (nitrendipine 10 mg plus captopril 50 mg), in patients suffering from mild to moderate primary hypertension, according to a single-blind, randomized, placebo-controlled design. After the first 4-week monotherapy period, both nitrendipine and captopril induced a significant decrease in systolic and diastolic blood pressure (BP) (p less than 0.001). Furthermore, nitrendipine caused a significant increase in heart rate (HR), while no change in HR was observed in patients treated with captopril. Several side effects were observed, both in the nitrendipine-treated patients (facial flushing, headache, malleolar edema) and in the captopril-treated patients (initial hypotension, dizziness, gastrointestinal disorders). However, these side effects were mild and were well tolerated. In the second combined 4-week therapy period, systolic and diastolic BP of patients treated with 10 mg nitrendipine combined with 50 mg captopril continued to decrease to a degree significantly lower (p less than 0.001) than that observed at the end of the monotherapy period. Simultaneously, no change in HR values occurred when compared to basal values. Furthermore, the incidence and intensity of some side effects observed during the combined therapy period were lower than those of the monotherapy period.(ABSTRACT TRUNCATED AT 250 WORDS)

Captopril

Acute cardiovascular and renal effects of human calcitonin gene-related peptide.

Acute cardiovascular and renal effects of 25 micrograms IV human calcitonin gene-related peptide (hCGRP) have been studied in four normotensive and untreated subjects, in the absence and the presence of indomethacin, a prostaglandin synthesis-blocking agent. Intravenous infusion of hCGRP, alone, caused a transient but significant increase in heart rate (HR), hypotension, and facial flushing. Along with these effects, a positive inotropic action of hCGRP was documented by a noninvasive poligraphy. Furthermore, a significant increase in the catecholamines (norepinephrine and epinephrine), in the cyclic nucleotide (cyclic AMP and cyclic GMP) plasma levels, and a small decrease in total calcium with no change in inorganic phosphorus serum levels, occurred. Also acute renal hCGRP induced effects were observed, as a significant increase in urinary volume and in the urinary calcium, sodium, potassium, and chloride excretion. Indomethacin did not affect all the cardiovascular, metabolic, and renal hCGRP-induced effects. These results are in agreement with the hypothesis that hCGRP acts on the heart, vessels, and kidney, directly or indirectly, by the mediation of other vasodilating agents or systems excluding the prostaglandin system.

Adult

Tolerability profile of the antiinflammatory compound imidazole salicylate: a metanalysis of safety data in 1408 patients.

In order to evaluate the incidence of side-effects (S.E.), the withdrawal rate and the type of S.E. of the new antiinflammatory agent imidazole salicylate, we performed an analysis of 33 clinical trials involving 1408 patients treated with 750 mg t.i.d. (tablets or solution) or 1000 mg b.i.d. (granulated powder), taking into account all the factors (treatment duration, pharmaceutical form, indications, etc.) that could influence the type and incidence of S.E. Slight and transient episodes of pyrosis or epigastric pain represented the great majority of S.E. The overall rate of withdrawal was 1.8%. According to the duration of therapy, the incidence of S.E. was: 2-3 days, 3.3%; 5-7 days, 5.6%; 10-14 days, 8.8%; 30 days, 10.2%. The pharmaceutical forms, the treated pathologies and the various experimental designs adopted (double-blind, open, etc.) did not influence the S.E. rate. With imidazole salicylate the overall incidence of S.E. was always lower than other NSAID's ranging from 10% to 64% of that observed with the reference drugs (other salicylates, ibuprofen, naproxen, flurbiprofen, piroxicam, diclofenac). In conclusion, this analysis showed a linear relationship between S.E. and exposure time up to 10-12 days, followed by a clear trend toward a plateau of 10% of S.E. with treatments up to 30 days. Therefore the risk-benefit ratio, particularly when compared with that of the reference drugs, seems to be very favourable.

Anti-Inflammatory Agents, Non-Steroidal

Pharmacokinetics and pharmacodynamics of propafenone during acute and chronic administration.

The pharmacokinetics of propafenone and 5-OH-propafenone and their relationship with the antiarrhythmic action and side effects have been studied in 10 patients with stable, frequent, premature ventricular beats (224-928 premature ventricular complexes/h). Observations were made after a single dose of propafenone 300 mg p.o., and after 1 and 3 months (only 5 out of 10 patients) of therapy with 300 mg t.d.s. After 1 month of treatment the plasma elimination half-life of propafenone (6.7 h) was almost twice as long as after a single dose (3.5 h), and the area under the plasma propafenone concentration-time curve (7620 ng.ml-1.h) was significantly larger than after single dose (3522 ng.ml-1.h); this was also true for the metabolite. The ratio of the AUCs of 5-OH-propafenone and propafenone decreased from the single dose (0.63) to 1 month (0.32). These variables remained stable up to 3 months. Eight patients had greater than or equal to 75% reduction of premature ventricular complexes after 3 days of therapy, and in 7 they were completely suppressed; the response was maintained over 1 to 3 months. Side effects were minor and in no case had the drug to be withdrawn or the dose reduced. Thus, the kinetics of propafenone were time-dependent. Its active metabolite did not accumulate greatly during chronic treatment. The lasting antiarrhythmic effect observed in some patients suggests a b.d.s. regimen instead of t.d.s. dosing in selected patients.

Adult

A two-year study of enteric infections associated with diarrhoeal diseases in children in urban Somalia.

A hospital-based systematic sample of 1667 children with severe diarrhoeal disease was studied in Mogadishu, Somalia, throughout 1983 and 1984. One or more enteric pathogens were found in 61% of the patients. Rotavirus (25%), enterotoxigenic Escherichia coli (11%), Shigella spp. (9%), Aeromonas hydrophila (9%), Giardia lamblia trophozoites (8%), Campylobacter jejuni (8%), and Vibrio cholerae non-O1 (6%) were the most frequently identified pathogens. Age-specific detection rates of enteric pathogens and helminths, seasonal patterns, and relationship of some specific infections with feeding status and main clinical features have been defined for all the sample examined.

Adolescent

[Treatment of essential mild-to-moderate arterial hypertension with once-daily penbutolol. Controlled clinical study vs atenolol].

The anti-hypertensive and tolerance of penbutolol, a non-selective beta-blocker of long duration and endowed with an ISA effect were compared with those of atenolol, a cardioselective beta-blocker without ISA effect, in two groups of 20 patients each suffering from slight-to-moderate essential primary hypertension selected on the basis of a clinico-experimental design of open randomised type. The two drugs presented a similar anti-hypertensive effect which attained its peak expression in the second week of treatment. As for side-effects, penbutolol during treatment presented better tolerance than atenolol. Further, both penbutolol administered once daily at a dose of 40 mg/die, and atenolol, administered once daily at a dose of 100 mg/die proved to possess satisfactory anti-hypertensive activity justifying its use in a single daily dose.

Adult

[Evaluation of the adrenergic and pressor response to the hand-grip test in young athletes].

Numerous factors may influence the sympathetic and pressure response to physical exercise, age, sex, type of activity carried on and training for example. Training, in particular is considered to reduce both adrenergic and pressure response. Plasma catecholamine levels and the haemodynamic response to the hand-grip test have therefore been evaluated in a group of young athletes, compared with a group of non-trained youths. The results confirmed that young athletes have a lower sympathetic and haemodynamic response to the isometric exercise and this is accompanied by improved cardiac performance. The value of the hand-grip test is underlined as a method of investigation able to evaluate the training level attained by the athlete.

Adult

The prevalence and intensity of intestinal parasites in two Somalian communities.

About 85% of the population of two Somali communities harboured soil-transmitted intestinal nematodes and/or protozoa. The commonest parasite (75% in the Lafoole institution and 59% in the Afgoye institution) was Trichuris trichiura. Mixed infections were common. The source of infection is contaminated fields around dwelling quarters, because of indiscriminate defaecation. One of the factors responsible for the higher incidence of hookworm in Lafoole (45%) compared with Afgoye (1.5%) may be the different soil character of the surrounding fields.

Adolescent

Circulating levels of catecholamines and cyclic AMP during the handgrip test in borderline hypertension.

Systolic and diastolic blood pressure, heart rate, and circulating levels of catecholamines and cyclic AMP were measured during the handgrip test in 18 borderline hypertensive patients, 22 stable hypertensive patients, and 20 normotensive control subjects. No difference was observed, at rest, for plasma levels of noradrenaline, adrenaline, dopamine, and cyclic AMP among the three groups. During the handgrip test in borderline hypertensive patients, the percentage of increase of plasma levels of noradrenaline, adrenaline, dopamine, and cyclic AMP were significantly more elevated with respect to the levels of control subjects but not when compared with those of stable hypertensive patients. These results are in agreement with the hypothesis that in both borderline and stable hypertension there is an exaggerated sympathetic response to the handgrip test.

Adult

Clinical evaluation of ceftazidime in high risk patients.

Ceftazidime was used in 19 patients at high risk owing to severe impairment of natural defense systems. The therapeutic efficacy and adverse reactions produced by cephalosporin, as evaluated on the basis of the results of clinical investigations and laboratory tests, were regarded as positive.

Aged

Blood pressure effects of acute hypercalcemia in normal subjects and thyroparathyroidectomized patients.

The effect of acute hypercalcemia on blood pressure and plasma catecholamine levels was investigated in 10 normal subjects and in 5 patients completely thyroparathyroidectomized (TPTX) for a parathyroid cancer. In normal subjects, calcium infusion (15 mg/kg over 3 h) significantly increased plasma calcium and epinephrine levels and blood pressure. Plasma norepinephrine was increased only after 3 h of calcium infusion. In TPTX patients, calcium infusion increased significantly plasma calcium and epinephrine but not blood pressure. The percent increase in mean blood pressure during calcium infusion correlated with the concomitant percent increase in serum calcium in normal subjects (r = 0.71, p less than 0.001) but not in TPTX patients (r = -0.08). These data are in agreement with the hypothesis that the effect of calcium on arterial pressure is realized under intact parathyroid function.

Adult

Influence of intravenous beta-adrenergic blockade with or without partial agonist activity upon plasma cyclic AMP and catecholamines in healthy subjects.

In a randomised within-subject double-blind study, 7 healthy male volunteers, aged 32 to 40 years, received at rest intravenous infusions of 2 mg propranolol (devoid of partial agonist activity), 2 mg oxprenolol (with partial agonist activity) and placebo. Cuff blood pressure did not vary after any of the 3 treatments. The heart rate did not change after placebo, but fell in the first 5 min both after propranolol and oxprenolol (p less than 0.01); the rate was slightly lower after propranolol than oxprenolol (p less than 0.05). The heart rate remained lower after both beta-blockers than placebo from 5 to 60 min after the infusion (both p less than 0.01), but the difference between the two beta-blockers was no longer significant. Plasma cyclic AMP showed a peak rise at 2 and 3 min after oxprenolol, and remained unchanged at those times after propranolol and placebo. From the 5th to the 60th min after infusion, the cyclic AMP concentration was lower after both beta-blockers than placebo, and with a slightly but not significantly higher level on oxprenolol than propranolol. Plasma noradrenaline and adrenaline were higher after the beta-blockers compared to placebo. Oxprenolol evoked a smaller and non-significant rise in both catecholamines. That oxprenolol, unlike propranolol, causes a sudden rise in plasma cyclic AMP soon after an i.v. infusion may be due to its partial agonist activity.

Adrenergic beta-Agonists