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Biomedical subjects

C Guarino

Publications and source records attributed to C Guarino.

At least 19 recordsLinked to original sources

[Correlation between functional and radiographic data, and broncho-alveolar cytology in patients with diffuse interstitial lung disease].

BACKGROUND: "Interstitial Lung Disease" is a term that includes a heterogeneous group of disorders characterized by variable degrees of parenchymal inflammation (alveolitis) and fibrosis. Alveolitis represents one of the most important aspects of ILD and its characterization by broncho-alveolar lavage (BAL) can give explanations of the different clinical features, in association with the evaluation of physiological changes and High Resolution Computed Tomography (HRCT). The aim of this study was to establish a correlation between variations in broncho-alveolar cells and anatomical-functional alterations in patients affected by ILD before and after corticoid therapy. METHODS: Thirty-one patients (14 males 17 females) were introduced in the study and were evaluated for clinical signs, functional parameters, HRCT and cyto-immunological aspects of BAL fluid. All data were acquired at the admission in the study, after 60 and 180 days. Patients had received prednisone 1 mg/kg/die for 60 days and, then, 0.25 mg/kg/die for 120 days. RESULTS: In lymphocyte alveolitis, a clinical-radiological improvement was frequently observed after therapy while in those with neutrophilic and eosinophilic components, no improvement was detected. CONCLUSIONS: In conclusion, BAL represents a useful tool in qualifying ILD which can be easily monitored by clinical, functional and radiological data. Therefore, a new method for the diagnosis and monitoring of ILD is suggested. This method has the marked advantage to reach a reliable diagnosis even in a high percentage of patients who refuse or can not undergo the biopsy assay.

Adult↗

Protective effects of nedocromil sodium on cellular and biohumoral components present in the bronchial alveolar lavage fluid and in peripheral blood in atopic asthmatics.

Nedocromil sodium, a disodium salt of a pyroquinolinedicarboxylic acid, raises the bronchial hyperresponsiveness threshold, because it inhibits the mediators released by the various cells, and reduces the involvement and activation of inflammatory cells. The aim of this study was to evaluate the state of activation of the immunocompetent cells and the main chemical mediators present in the bronchoalveolar lavage (BAL) fluid from 10 atopic asthmatic patients, before and after treatment with nedocromil sodium. The following examinations were performed before treatment and after 120 days of therapy with nedocromil sodium at 16 mg/day (two 2-mg puffs x 4): the level of chemical mediators and the state of activation of immunocompetent cells in BAL fluid; immunological analytes in activation of immunocompetent cells in BAL fluid; immunological analytes in peripheral blood; aspecific bronchial challenge test with ultrasonicated bidistilled H2O fog to evaluate variations in the hyperreactivity threshold; questionnaire to determine any adverse effects of treatment (cough, breathlessness, sleep disorders). Our findings demonstrate that nedocromil sodium prevents the release of chemotactic and inflammatory mediators by the effector cells and thus stabilizes microvascular permeability and epithelial damage, so raising the threshold of response to bronchoconstriction stimuli. Lastly, nedocromil sodium is associated with a better preventive therapeutic efficacy and good tolerance and can therefore be suggested as a valid drug to be used in the long-term treatment of bronchial asthma.

6-Ketoprostaglandin F1 alpha↗

Levodropropizine in the premedication to fibrebronchoscopy.

The aim of the study was to evaluate the efficacy of cough-preventing treatment with levodropropizine, a drug inhibiting peripheral cough reflexes, in patients undergoing bronchial endoscopy. Sixteen patients, aged 37-73 years, suffering from chronic obstructive lung disease in the hypersecretory phase, were included in the study. The experiment was designed as double blind with double observer, controlled versus placebo. As comparative efficacy parameters were considered the number of anaesthetic boluses (lidocaine at 2%) administered during and immediately after the manoeuvre. The number of coughs during and 10 min after bronchoscopy was registered on a magnetic tape and read by a blinded observer thereafter. Levodropropizine was given as oral drops (20 each time, equal to 60 mg active drug) 12 h and 1 h before bronchoscopy. Data analysis was performed by descriptive statistical tests and by the non-parametric Wilcoxon test for paired samples. Levodropropizine treatment significantly reduced the number of anaesthetic enemas (p less than 0.01), and presented an excellent tolerability and safety profile.

Adult↗

Alterations of the endoalveolar surfactant after surgery with extracorporeal circulation.

In 10 patients who required extracorporeal circulation (ECC) during surgery, we studied the damage induced by surgery to the pulmonary surfactant and the effectiveness of ambroxol in preventing changes in the phospholipid pool. There were 5 control patients and 5 patients who were given 1 g/day of ambroxol on the 4 days prior to and the 4 days after surgery. To follow changes in phospholipid concentrations, bronchoalveolar lavage (BAL) was performed before surgery and 24 h and 8 days after ECC. Phospholipids were assayed in the BAL liquid by two-dimensional thin-layer chromatography. There were marked decreases in total phosphorus and quantitative alterations of individual phospholipid species in the surfactant of the control group, but not in the patients treated with ambroxol.

Adult↗

Treatment of lower respiratory tract infections with ceftriaxone and cefotaxime. A comparative study.

The microbiological and clinico-therapeutic efficacy and safety of ceftriaxone were compared with those of cefotaxime in an open randomized trial. Fifty-four adult hospitalized patients (37 males and 17 females) suffering from either acute bronchopneumonia (19) or acute exacerbations of chronic bronchopneumonia (35) have been investigated. Four patients were withdrawn from the trial. Underlying diseases were present in 41 patients. Ceftriaxone was administered at a once-a-day dose of either 1 or 2 g (in 13 and 14 patients, respectively) and cefotaxime at a 2 g twice daily dosing regimen (27 patients), both antibiotics being given for 7-12 days. In the ceftriaxone group, 15 out of the 27 patients were cured (55%) and 9 had a favourable clinical response for a total satisfactory response rate of 88%. The causative pathogen was eliminated in 18 (66%) patients. The results obtained in the cefotaxime group did not differ significantly, but 2 patients were excluded from the study because of in vitro resistance of the causative pathogen isolated. Both drugs were well tolerated: no relevant laboratory changes were registered. The results indicate that ceftriaxone at a dosage of 2 or 1 g daily is at least as effective as cefotaxime given daily at a dosage of 4 g in the treatment of severe lower respiratory tract infections.

Adolescent↗

Comparative clinical evaluation of ceftriaxone in treating lower respiratory tract infections.

To evaluate the clinical and microbiological efficacy and safety of ceftriaxone in comparison with cefotaxime in treating acute lower respiratory tract infections two open randomized trials were performed. Sixty-two adult hospital in-patients were entered and 58 completed the study. The patients suffered from either acute (broncho-)pneumonia (19pts) or severe exacerbation of chronic bronchopneumonia (39 pts). Forty-one of the patients had severe underlying or concurrent diseases. Diagnoses were in all cases confirmed by isolation of the causative pathogen(s) from bronchial brushing or washing under fiberoptic bronchoscopy. Twenty-eight patients were administered at random with either a single 2g daily dose of ceftriaxone or 2g twice daily dose of cefotaxime (1st trial). Successively (2nd trial) ceftriaxone was administered at a dose of 1g once daily either i.v. or i.m. The duration of treatment ranged from 7 to 12 days. A satisfactory response was observed in all patients suffering from acute pneumonia or bronchopneumonia; the eradication rate of the causative pathogen was 73% and 62% for ceftriaxone and cefotaxime, respectively. Concerning the exacerbation of chronic bronchopneumonia (39 patients) an overall satisfactory response to both treatments was registered in about 80% of cases. No significant differences between the 1g and 2g single daily dosing regimens of ceftriaxone appeared. Both ceftriaxone and cefotaxime were well tolerated: no or minimal changes in laboratory values were noticed. It is concluded that a 1g or 2g single daily dose of ceftriaxone were at least as effective as a 2g twice daily dose of cefotaxime in treating acute lower respiratory tract infections due to susceptible pathogens.

Adult↗

Preliminary report on antimicrobial activity of Helichrysum litoreum Guss.

The authors present the preliminary results regarding the antibacterial action of extracts of Helichrysum litoreum Guss. The leaves and the young stems of this species, gathered on the slopes of Mt Vesuvius, in the Campania region, were ground and four extracts were made as follows: with dichloromethane, ethanol and water (70:30 v/v), water and methanol. The antibacterial activity of each of the samples was tested in order to determine which of the extracts was more antibacterial. The results of the test showed that the extract with the ethanol/water (70/30 v/v) was the most active one. This will allow us to advance in the research, purifying the extract and hopefully identifying the active principles.

Anti-Bacterial Agents↗

[Multiple carcinomas: considerations on several cases with synchronous/metachronous involvement of the respiratory tract].

The authors report their observations on 7 cases of multiple malignant tumors during the period 1988/1992 (frequency of 0.03 x 100). They report that primary malignant tumors involved the laryinx and the wang, and both the lungs in a synchronous or metacronous way. They suggest that pathogenesis of multiple malignant tumors may be very similar to that of multiple endocrinous neoplasms.

Aged↗

[Pulmonary tuberculosis today. The findings over a 5-year period in a ward for women].

The authors studied the cases of pulmonary tuberculosis they had the opportunity to observe during a five-year period from 1985 to 1989 carrying out the phenomenon. As a result they pointed out that the worst affected subjects belonged to the age bands included between the second and the third decade, followed by the fifth decade and over. They concluded that the 234 cases they examined do not represent the real number of affected subjects and that elderly patients to the most serious cases.

Acute Disease↗

[Diagnostic role of BAL in pulmonary alveolar microlithiasis].

From 1982-90, 3721 fiber bronchoscopies were performed for the diagnostics of diffused alveolar-septal pathologies; BAL was performed in 400 cases. Alveolar pulmonary microlithiasis was diagnosed in 6 patients, and two of them were related. The staging and the evolution of the pathology were evaluated as follows: chest x-ray in various projections, calcemia, lung function tests, fiber bronchoscopy with analysis of BAL and quantitative evaluation of macrophagic and lympho-monocytic elements and in percentage of calcosferitics. Four patients were treated with therapeutic BAL in the lungs with normal saline, and the cytological results and the percentage of calcosferitics were monitored for 24 months.

Adolescent↗

[Cefotetan treatment of suppurative bronchopulmonary syndromes sustained by anaerobic germs].

The Authors have analyzed the effect of Cefotetan in 20 patients affected by bronchopulmonary pathologies supported by anaerobic bacterium. During 7 days doses of 50 mg. pro Kg/pro die were given. From beginning to end of the treatment clinical, hematochemical and radiological data were evaluated. Bacteriological analysis was made on samples drawn with BFS according to a traditional method and with microbiology specimen brush. Almost all the patients (95%) realized improvements in clinical symptomatology and in radiological picture.

Adolescent↗

[Incidence of cefotetan sensitivity in anaerobic microbes responsible for acute and chronic relapsing bronchopneumonia].

Bronchial fluid samples obtained from 50 patients with respiratory tract infections were analyzed for anaerobic flora isolation, identification of micro-organisms and evaluation of their sensitivity to cefotetan. Anaerobic strains were identified in 18 patients (36%), generally with exacerbations of chronic diseases: cefotetan was active on 100% of isolates.

Acute Disease↗