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Biomedical subjects

C Grassi

Publications and source records attributed to C Grassi.

At least 73 records · Page 4Linked to original sources

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

Pneumonia today.

Explore the source record for details and available documents.

Anti-Bacterial Agents

Effect of (dl) 3,7-dihydro-1,8-dimethyl-3-(2-methylbutyl)-1H-purine-2,6-dione on exercise-induced bronchospasm.

The authors studied the clinical activity of a synthetic theophylline derivative, (dl)-dihydro-1,8-dimethyl-1-3-(-2-methyl-butyl)-1 H-purine-2,6 dione, both after short-term treatment and in prevention of Exercise-Induced Asthma (EIA). The action of the new compound at two dosages was compared with that of anhydrous theophylline at a standard dose of 600 mg/day. The trial included 15 asthmatics, 11 males and 4 females, who showed EIA with reversible bronchospasm (improvement of at least 15% of FEV1 after administration of salbutamol at a dose of 200 mcg by means of a predosed aerosol). Asthma had been provoked by free running on a flat surface. The test was considered positive if the FEV1 was reduced at least by 20% compared with baseline level. Only 11 patients completed the protocol. In four cases the treatment had to be withdrawn due to the onset of adverse side effects. After 3 days of treatment, the drug caused a statistically significant improvement of FEV1 in comparison with baseline, but no difference from that caused by theophylline. Likewise no significant difference was noted between low and high doses of the tested drug. As regards the behavior of EIA under treatment, in 8 of 14 patients theophylline and the investigational drug proved equally effective. Two patients were protected only by theophylline, one only by the investigational drug, and three failed to be protected by either agent. The higher dose of the investigational drug protected against EIA in all the subjects protected by theophylline with one exception. Of the two doses tested, the lower one should be preferred since it has the same therapeutic effect without the most important side effects.

Adult

[Respiratory functional evaluation in surgical patients].

Preoperative respiratory evaluation is examined in the light of factors likely to influence the conduct of the operation and its subsequent course. The methods required for this purpose are reviewed. Attention is first given to changes in specific respiratory components (alveolar exchange surface area, ventilation, diffusion and circulation) and their associated activities (chest mechanics, pulmonary circulation, motor nervous system), and those dependent on the type of surgery (lung, chest, abdomen, other parts). Next, the measurement methods available, the criteria for evaluating the data, and the criteria whereby candidates are selected for emergency surgery, surgery after thorough checking and extensive examination, general surgery, and chest surgery are explained. Lastly, the specific case of patients with typically respiratory diseases is discussed.

Asthma

A comparison between different methods for detecting bronchial hyperreactivity. Bronchial hyperreactivity: methods of study.

The authors evaluated bronchial hyperreactivity comparing two different methods for aspecific bronchostimulation (H2O ultrasonic mist and free running) and a bronchodilation test. The investigation had been carried out on three groups of subjects. The first included 15 nonsmoking normal subjects, the second 23 asthmatic patients and the third 16 rhinitic patients. All subjects were submitted to bronchodynamic tests in three different ways. The ventilatory parameters were FVC, FEV1, MMEF and Vmax25. In normal subjects no significant changes were found. In asthmatic patients the bronchodilation test was positive in 65% of the cases, regarding FEV1 and in 87% regarding the forced flows. The running test was positive in 26% of the cases (FEV1) and in 61% of the cases (forced flows). The ultrasonic mist caused a significant drop in FEV1 in 17% of the cases, while flows were significantly reduced in 30% of the cases. In rhinitic patients the bronchodilation test was positive in 25% of the cases both considering FEV1 and forced expiratory flows. Ultrasonic mist never induced a decrease of FEV1, while flows decreased in 12.5% of the cases. The free running test was positive in 12% of the cases regarding FEV1 and in 25% regarding forced flows.

Adolescent

Clinical efficacy trial: theophylline vs (dl) 3,7-dihydro-1,8-dimethyl-3-(2-methylbutyl)-1H-purine-2,6-dione.

The authors give a synopsis of the results of a clinical efficacy trial involving a comparison of a new synthetic xanthine derivative (CK 0383) and theophylline, with emphasis on the prevention of exercise-induced asthma (EIA) by both theophylline and the new drug. Although the results are quite preliminary, being based on only five cases, the authors are continuing this study due to findings that show CK 0383 has a good bronchodilating activity without any important side effects.

Adolescent

Clinical pharmacology of a combination of bronchodilators.

27 hospitalized patients (15 suffering from chronic bronchitis with evident bronchospasm and 12 with extrinsic asthma) were evaluated with regard to the bronchodilating effects of a Salbutamol + Ipratropium Bromide combination administered by aerosol. For comparison, the bronchial spasmolytic effectiveness of both drugs administered separately at therapeutic doses was also evaluated. Subsequently, the activity of increasing doses of the combination was studied, with particular regard to possible side-effects. The pharmacological combination studied exerted a strong bronchodilating activity, independently of dose increase, both in asthmatic and in bronchitic patients. No side-effects were observed.

Aerosols

[Functional diagnosis of bronchospasm].

The main theories concerning the pathogenesis of bronchospasm are cited and reference on is made to the part played by the respiratory physiopathology laboratory with respect to past or present patients with this symptom. Attention is then directed to the action of bronchodilatatory substances in the resolution of a proven state of bronchospasm. Administration modalities, techniques, parameters, and percent improvements considered as significant in the light of the literature data and personal experience are illustrated. Bronchoprovocation tests are briefly reviewed. These are divided into aspecific and specific, according to the mediator employed. The first group involve the action of distilled water, physical effort, F2alpha prostaglandins, acetylcholine, and propranolol. The second, which are much more delicate, less certain in their meaning, and not entirely risk-free, offer information of a general nature and impose the need for due care in their practical application.

Airway Resistance

[Indications for and limitations of the exercise tests in respiratory physiopathology].

Following a review of the physiology of the subject, attention is concentrated on the significance of O2 consumption during exercise. The stages through which O2 passes prior to being used by the muscles are discussed, i.e. respiratory, cardiocirculatory, haematic, metabolic-tissue stages. Subsequently, the methods most commonly employed to evaluate the capacity of a patient to withstand an exercise test are illustrated and discussed. The various types of ergometers are covered first, the positive and negative features of each being indicated. The various tests are then described, these being subdivided according to their intensity into maximal and submaximal tests and, according to the load, into tests with constant load, increasing load, continuously growing load and variable load. The salient features of each are listed. The measurements (parameters, units, indices) that may be used and the standards to be observed on the basis of W.H.O. and EEC proposals are considered. After presenting the factors on the basis of which an exercise test may be appraised in relation to its purposes, the criteria for interpreting results in healthy and sick subjects are examined, with particular attention being paid to pneumo-patients and those with heart diseases. Particular stress is laid on the variations in certain basic parameters, such as Maximum withstandable effort, Oxygen debt, Maximum aerobic work, Ventilation break point and the behaviour of Haemogasanalytic, ECG, Cardiac output and Pulmonary artery pressure data in normal and pathological situations.

Blood Pressure

[Methods for the determination of VA/QC ratio].

Physiological considerations relevant to a general understanding of the question are put forward and the main methods used for determining the ventilation-perufsion ratio are described. Over-all methods offer generic evaluation of a change, particularly the method whereby the alveolus/arterial PO2 gradient is measured on straight lines expressing the different points of gas and blood respiratory exchanges, and that which measures the triple CO2, O2 and N2 alveolus/arterial gradient. Methods employed to evaluate the distribution of ratio changes are also explained: evaluation with CO2 labelled with 15O2, 133Xe, 13N2 and 85Kr, using pairs of scintillators, scanning detectors, gamma camera or special cuvettes, and analysis of respiratory He, Ar, O2, CO2, N2O and CHF2Cl at the mouth and inside the lung, using rapid analysers and single or multiple breath methods, or analysis of gas elimination coefficients. It is felt that measurement of the VA:Qc ratio is now within the capacity of all laboratories, so that qualitative, semi-quantitative and quantitative assessment can be made not only of the ability to ensure efficient alveolar exchange on the part of ventilation and circumation, but also of the presence of compensated changes, or the simultaneous presence of other alterations of various kinds, which cannot be readily detected by using conventional methods.

Bronchi

Use of a modified thromboelastograph to evaluate effects of acetylcysteine on sputum.

This work deals with a modification of a thromboelastograph which enables to measure both in vitro and in vivo effectiveness of mucolytic substances. A simple method is described for building up a comparative diagram of the effectiveness of several drugs; a diagram which is of interest from both a pharmacological and a clinical point of view.

Acetylcysteine