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Biomedical subjects

C Grassi

Publications and source records attributed to C Grassi.

At least 55 records · Page 3Linked to original sources

A review of clinical studies carried out in Italy with almitrine bismesylate.

The authors refer to a double-blind versus placebo multicentric study, carried out in Italy on 128 hypoxaemic patients suffering from COLD, with Almitrine bismesylate, a new chemoreceptor stimulant drug, given by mouth for a period of two months. Almitrine induced significant changes (p less than 0.001) of PaO2, with a mean increase of 7.6 mmHg, and of PaCO2, with a mean decrease of 4.1 mmHg, without variations of lung volumes and caliber of large and/or small airways. Almitrine, well tolerated within the time limits of this trial, seems an effective oral respiratory drug, acting through a favourable effect on V/Q mismatching due mainly to a reduction of the shunt effect, but also to an improvement of the ventilatory pattern.

Almitrine

Controlled trial of methylprednisolone pulses and low dose oral prednisone for the minimal change nephrotic syndrome.

In a multicentre, randomised, prospective trial 89 patients (67 children and 22 adults) with the minimal change nephrotic syndrome were treated with three intravenous pulses of methylprednisolone followed by low dose oral prednisone for six months (group given methylprednisolone) or with high dose oral prednisone for four weeks followed by low dose oral prednisone for five months (control group). Five patients in the group given methylprednisolone and one in the control group did not respond initially. The time to response was shorter in children treated with methylprednisolone. No significant differences between the two groups were observed in the number of patients who relapsed or number of relapses per patient per year. Patients given methylprednisolone tended to relapse earlier than patients in the control group. Side effects related to treatment were significantly fewer in the group given methylprednisolone than in the control group. These data suggest that a short course of methylprednisolone pulses followed by low dose oral prednisone is only marginally less effective than a regimen of high dose oral steroids but can improve the ratio of risk to benefit associated with treatment of the minimal change nephrotic syndrome.

Administration, Oral

Sympathetically-induced development of tension in jaw muscles: the possible contraction of intrafusal muscle fibres.

In rabbits, cats and rats anaesthetized, curarized, with the skull fixed in a stereotaxic apparatus, the peripheral stump of the cervical sympathetic nerve (c.s.n.) was electrically stimulated at frequencies within the physiological range and the isometric tension was recorded at the lower jaw. In a group of experiments the afferent discharge from the jaw elevator muscle spindles was also recorded, in the mesencephalic nucleus of the fifth cranial nerve. Unilateral stimulation of the c.s.n. induced in jaw elevator muscles of rabbits an increase of tension of 5.5 +/- 0.5 g (latency: 0.5-2 s, time constant: 2.5-5 s) maintained with little or no decrement until the end of stimulation. This response proved not to be secondary to vasomotor changes since: i) approximately half of it was mediated by the fastest conducting component of the c.s.n. fibres, ii) it was not mimicked by a sudden reduction of blood supply to the muscles, iii) it was unaffected by 10 min bilateral occlusion of both the external and the internal carotid arteries. During c.s.n. stimulation the afferent discharge from spindles belonging to jaw elevator muscles exhibited an increase of firing (often preceded by a transient decrease) lasting throughout the stimulation. Also, the position sensitivity of all the spindle afferents tested was modified by the sympathetic stimulation. The results presented are interpreted to suggest that the sympathetic system may induce an intrafusal muscle fibre contraction in jaw elevator muscles. The possible functional implications are also discussed.

Animals

Pharmacokinetic studies on antituberculosis regimens in humans. I. Absorption and metabolism of the compounds used in the initial intensive phase of the short-course regimens: single administration study.

The absorption and metabolism of streptomycin, isoniazid, rifampicin, and pyrazinamide were evaluated after administration of each drug alone and in combination. In the combination sessions, isoniazid, rifampicin, and pyrazinamide were administered orally, either individually or in a single fixed-ratio triple preparation. The results have shown that the pattern of absorption and metabolism (acetyl-isoniazid, desacetyl-rifampicin, and pyrazinoic acid) found after administration of each drug alone did not differ from that found after administration of the drugs in free and fixed combination. The 3 orally administered drugs given in a fixed combination resulted in a reduction of the order of 50% of the total number of tablets to be ingested.

Absorption

[The first Italian clinical experience with almitrine bismesylate].

A double blind randomised multicentre clinical trial against placebo was performed in Italy on 128 patients with chronic airflow obstruction and hypoxaemia. On entry to the study all the patients were hypoxaemic (PaO2 less than or equal to 70 mmHg), 22 were normocapnic (PaCO2 less than or equal to 41 mmHg), 106 hypercapnic (PaCO2 greater than or equal to 43 mmHg). The patients (107 males and 21 females) with a mean age of 64 received oral Almitrine bismesylate for two months in a dose of 100 mg per day or placebo taken in two doses with the main meals. After inclusion in the study (TO), patients were reviewed after 30 and 60 days of treatment to evaluate pulmonary function and blood gases. The results were as follows: Almitrine bismesylate did not produce any significant variations in lung volumes, tests of airflow obstruction (for large or small airways) or the distribution of intra-pulmonary inspired air. The blood gas values at the end of treatment showed statistically significant changes (p less than 0.001: PaCO2 + 7.6 mmHg in patients overall and PaCO2 - 4.1 mmHg in those patients with hypercapnia.) The changes in arterial blood, already apparent after 30 days, were even more marked at the end of the study. These favourable blood gas changes might be the result (for the greater part) of the intra-pulmonary haemodynamic effect induced by Almitrine bismesylate (improved VA/QC ratios described in the literature) and (for a smaller part) a better ventilatory pattern with a reduction in the (A-a) DO2 and the functional dead space.(ABSTRACT TRUNCATED AT 250 WORDS)

Almitrine

Respiratory infections: clinical evaluation.

A review of clinical studies of piperacillin shows that it is valuable for the treatment of respiratory infections due to Enterobacteriaceae, Pseudomonas sp, anaerobes, and mixed flora including anaerobes. Various studies of a total of 420 patients treated with piperacillin for lower respiratory tract infections found that 97% of the patients were cured or markedly improved. Piperacillin has also been found as effective as combination therapy (gentamicin or tobramycin plus carbenicillin or ticarcillin) in the treatment of serious infections, including pneumonia and several caused by gram-negative organisms and anaerobic organisms. A review of the literature on bacteriological responses to piperacillin shows that 126 of 153 (82%) of the susceptible strains could be eradicated. Streptococcus pneumoniae, beta-hemolytic streptococci, Haemophilus influenzae, Peptostreptococcus sp, Bacteroides sp, and Fusobacterium sp have been completely eradicated by treatment with piperacillin. Most of the published studies indicate that therapy with the drug is usually well tolerated.

Amikacin

Visual evoked potential recordings in hepatic encephalopathy and their variations during branched chain amino-acid treatment.

In fourteen subjects with various stages of hepatic encephalopathy (HE), Visual Evoked Potential (VEP) recording and blood ammonia (NH3), octopamine (OCT) and phenylethanolamine (PEA) determinations were performed before and during a four-day treatment with branched chain amino acid (BCAA) i.v. infusion. All the subjects with HE showed significant basal VEP alterations, namely an increased latency and a lowered amplitude of the P100 wave, in comparison with a control group of 26 normal subjects. A significant improvement in P100 wave amplitude occurred just about 60' after the beginning of BCAA infusion, while P100 latency was still unaffected, as were OCT, PEA and NH3 levels. After the fourth day of BCAA treatment, both P100 wave amplitudes and latencies were strongly improved, together with OCT, PEA and NH3 levels. VEP improvements seemed to be well correlated with HE clinical evolution, and were able to detect modifications of central nervous system reactivity earlier than serum parameters.

Adult

Controlled trial of methylprednisolone and chlorambucil in idiopathic membranous nephropathy.

Sixty-seven adults with idiopathic membranous nephropathy and the nephrotic syndrome were randomly assigned to symptomatic treatment only or to a six-month course of methylprednisolone alternated with chlorambucil every other month. Patients were followed for one to seven years. At the end of follow-up (mean of 31.4 +/- 18.2 months for the treated group and 37.0 +/- 22.0 for the control group) 23 of 32 treated patients were in complete or partial remission, as compared with 9 of 30 control patients (P = 0.001). Twelve of the treated patients were in complete remission, as compared with only two of the controls. In the treated group there were no changes in renal function during follow-up, whereas in the control group the reciprocal of the plasma creatinin level, which is proportional to the creatinine clearance, decreased significantly (P = 0.00017) after two years of follow-up. Side effects were minimal in all treated patients except two, who were dropped from the study because of peptic ulcer and gastric intolerance to chlorambucil. We conclude that steroid and chlorambucil treatment for six months favors remission of the nephrotic syndrome in adults with idiopathic membranous nephropathy and can preserve renal function for at least some years.

Adult

[Evolution of the treatment of tuberculosis].

An evolution analysis of tuberculosis management includes four essential times. The first time coincides with the streptomycin therapeutic employment; the second develops with isoniazid disposing; the third time takes in the period of identification of several drugs a long time called "minor", but very important to formulate some "ad personam" therapeutic patterns. At last, the fourth time is characterized by formulation of short-course chemotherapy. Now the suggested protocol is a regimen of short-course chemotherapy with daily administration of INH and RIF for six-nine months with an initial supplement of ethambutol, or streptomycin or pyrazinamide for the first two months.

Ambulatory Care

Interaction between cytochrome c and ubiquinone-cytochrome c oxidoreductase: a study with water-soluble carbodiimides.

The role of carboxyl groups on the interaction between ubiquinone-cytochrome c oxidoreductase (Complex III) and cytochrome c has been probed using the two water-soluble carbodiimides EDC (1-Ethyl-3-(3-dimethylaminopropyl) carbodiimide) and CMC (1-cyclohexyl-3-(2-morpholinyl-4-ethyl) carbodiimide metho-p-toluensulphonate). The results suggest that: 1) carboxyl groups present on both cytochrome c1 and subunit VIII are modified. Some of these residues are shielded by cytochrome c. 2) The enzyme activity decreases during the carbodiimide treatment and the extent of inhibition is larger in the presence of cytochrome c. 3) Cytochrome c, equimolar with the enzyme, cross-links to cytochrome c1 and subunit VIII via the carbodiimide-activated carboxyl groups. The two subunits appear to be in contact in the isolated enzyme.

Animals

Controlled trial of monthly alternated courses of steroid and chlorambucil for idiopathic membranous nephropathy.

Forty-nine patients with membranous nephropathy (MN) and nephrotic syndrome (NS) were randomly allocated to supportive or specific therapy. The latter consisted of steroids or chlorambucil given in alternate months for a cumulative period of six months. Three patients in the experimental group were dropped from the study because of therapy related side-effects. At the end of follow-up there were significantly more patients in complete or partial remission in the experimental group than in the controls. The mean serum creatinine did not change in treated patients, but it significantly increased in controls.

Chlorambucil