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Biomedical subjects

D Olivieri

Publications and source records attributed to D Olivieri.

At least 91 records · Page 5Linked to original sources
PubMed1987

Ambroxol for the prevention of chronic bronchitis exacerbations: long-term multicenter trial. Protective effect of ambroxol against winter semester exacerbations: a double-blind study versus placebo.

In a 6-month, double-blind multicenter trial conducted over the winter, the effects of daily administration of ambroxol retard (75 mg) were compared with those of placebo in preventing exacerbations and improving symptoms and clinical signs in chronic bronchitis patients. The trial was completed by 110 patients in the ambroxol group and by 104 in the placebo group. Initially, there were no significant differences between the groups. By the end of the 2nd month of treatment, 67.2% of the ambroxol group had had no exacerbations compared to 50.4% in the placebo group. At the end of the 6-month trial, 45.5% of the treatment group had had no exacerbations, compared to only 14.4% of the control group. These differences were statistically significant. Patients in the treatment group lost significantly fewer days through illness (442) and had fewer days when they needed antibiotic therapy (371) compared to the placebo group patients (837 and 781). Ambroxol also produced statistically significant symptomatic improvement, measured as difficulty in expectoration, coughing, presence of dyspnea and the auscultatory signs as compared to controls. Since ambroxol was well tolerated and compliance was good, it appears like a drug of choice for pharmacological prophylaxis of chronic bronchitis.

Adult↗
PubMed1987

Provocative dose and dose-response curve to inhaled propranolol in asthmatic patients with bronchial hyperresponsiveness to methacholine.

This study was carried out to compare bronchial responses to inhaled propranolol (P) and methacholine (M) in a group of asthmatic subjects with mild to moderate bronchial hyperresponsiveness to M; to determine the short term reproducibility of bronchial response to propranolol; and to examine the shape of dose-response curve to P relative to that of M. Doses of M and P were given in mumoles and bronchial responses to both agents were expressed as the provocative dose that induced a 20 percent fall in FEV1 (PD20 FEV1). In 16 asthmatic patients, there was no correlation between the PD20 of the two agents. Mean PD20 M (+/- SD in log scale) was approximately nine times lower than mean PD20 P (0.64 +/- 0.96 and 5.80 +/- 1.65, respectively). This difference was statistically significant (t = 4.58, p less than 0.001). In six asthmatic patients, the reproducibility of PD20 P was similar to that of M (intraclass correlation coefficient 0.969 and 0.957, respectively). The shape of the dose-response curves to P was different from that of M in five of nine asthmatic patients when all experimental points were analyzed by double-reciprocal plot. We noticed that even small doses of inhaled P may cause a severe bronchoconstriction. Therefore, special caution should be taken to increase P doses very gradually, when studying the dose-response curve. We demonstrated that P inhalation induced a measurable bronchoconstriction in subjects with mild to moderate hyperresponsiveness and it was reproducible. However, the bronchial sensitivity to P was lower than to M. Our findings suggest that P and M have different mechanisms of action.

Asthma↗
PubMed1985

[Prediction of the presence and severity of coronary arteriopathy and left ventricular dysfunction by discriminant multivariate analysis of the exercise test].

266 male p., with chest pain and without previous myocardial infarction were studied by exercise test and coronary arteriography. 17 had no coronary disease (group C-0), 22 had less than or equal to 50% coronary stenosis (C-1), 65 had severe 1 vessel disease (C-2), 73 had 2 vessel disease (C-3), 89 had 3 vessel disease (C-4). 95 had normal ventricular function (group V-0), 111 had hypokinetic ventricular segments (V-1) and 60 had akinetic ventricular segments (V-2). 11 exercise test variables were stepwise selected to discriminate the C-groups and the V-groups. For C-groups significant variables were: test result, heart rate increment, number of leads, work load, rate-pressure product, systolic pressure increment. By 4 discriminant functions, 41% p. were correctly classified. For V-groups significant variables were: hear rate increment, test result, effort angina, rate-pressure product, number of leads, ST depression, ST configuration, age. By 2 discriminant functions 53% p. were correctly classified.

Adult↗
PubMed1985

Immunology of pulmonary disease--profile of the granuloma.

Granuloma formation in the lung is initiated by a diversity of antigens and other agents including infection, chemicals, organic dusts and metabolic disturbances, all of which lead to chronic parenchymal inflammation and a varying expression of cellular infiltration, necrosis, vasculitis and fibrosis.

Granuloma↗
PubMed1985

Improvement of mucociliary transport in smokers by mucolytics.

The purpose of the present study was to compare the effects of two mucolytic drugs with different mechanism of action on mucociliary transport (MCT). N-acetylcysteine (NAC-600 mg/day) and ambroxol (AMB-90 mg/day) were administered according to a double-blind cross-over scheme to 12 heavy smokers suffering from hypersecretory bronchitis and homogeneous reduction of the MCT. Placebo of both treatments was administered during an interval of ten days between the administrations of NAC and AMB. The entire treatment period was 30 days. The data were analyzed according to ANOVA for the two-period cross-over clinical trial. The results indicate that: NAC and AMB, administered both before and after placebo, produce a significant increase in MCT, NAC showed a slightly greater efficacy than AMB, but the differences are not statistically significant. The overall efficacy of NAC and AMB is consistently greater than that of placebo. The sequence of administration of the drugs does not influence their effect.

Acetylcysteine↗
PubMed1984

Fat infusion and blood coagulation in patients undergoing surgery for esophageal cancer.

Twenty-six patients with stage III and IV esophageal cancer were randomly studied to evaluate the influence of fat emulsions (Intralipid) infusion on blood coagulation during total parenteral nutrition (TPN). The patients were divided into two groups: the first group (13 patients) received 24h. TPN; in the second group (13 patients) 1000 ml of 10% Intralipid were added to TPN via a peripheral vein over a period of 12 h. (1.8-2.1 g/kg/day). Primary hemostasis, platelet adhesiveness, alterations in fibrin formation and risk factors were evaluated before treatment (Time 0), after 7 days (Time 1) and after 14 days (Time 2). Statistical analysis of results was also carried out. On the basis of the obtained results it is observed that Intralipid at the administered doses, did not cause any alterations in blood coagulation and particularly in platelet adhesiveness.

Blood Coagulation↗
PubMed1983

Anti-anginal effect of oral verapamil: evidence of dose-dependence of the effect.

The anti-anginal effect of oral verapamil was assessed in 12 patients with chronic effort-induced angina, using a single-blind, placebo-controlled protocol. The patients were given, in random order, placebo, verapamil 240 mg/day, verapamil 360 mg/day, for 24 hours, followed by a 24-hour washout period. Increase in tolerated work load, compared to a baseline bicycle exercise test, was -25 +/- 55.9 kgm/min on placebo, 137.5 +/- 96 on verapamil 240 mg/day, 212.5 +/- 129.3 on verapamil 360 mg/day (p less than 0.001). While taking verapamil in 9 patients 240 mg/day the test was interrupted with of ECG alterations; at the same work load, only 1 patient had ECG alterations while taking verapamil 360 mg/day (p less than 0.01) and 9 completed the test without ECG alterations. The pressure-rate product at maximum exercise was not significantly affected by treatments. The higher dosage of verapamil prolonged the P-R interval (p less than 0.01) but only 1 patient had first-degree AV block. It is concluded that verapamil is a powerful and safe drug in the treatment of effort-induced angina: there is evidence that the effect depends on the dosage administered.

Adult↗
PubMed1982

Isosorbide dinitrate alone and in association with intra-aortic balloon counterpulsation in acute myocardial infarction. A clinical study by precordial ECG mapping.

The effects of the association of Isosorbide Dinitrate (ISDN) and Intra-Aortic Balloon Counterpulsation (IABCP) on ECGphic signs (in 24-lead precordial maps) of myocardial damage were studied in 7 patients (pts) with anterior acute myocardial infarction (AMI) without cardiogenic shock and/or pulmonary congestion, admitted to the CCU within 6 hours (hrs) since the chest pain. Matched control group consisted of 7 pts treated with ISDN alone. Analysis of variance showed that the association of IABCP and ISDN influenced favourably (p less than 0.01) the trend of the sigma ST (in all leads and in those with ST segment elevation greater than 0.2 mV), of the ST and of NST. The trend of sigma R was similar in the two groups. sigma Q was influenced either by time and by therapy; NQ was significantly lower (p less than 0.01) in pts treated with ISDN and IABCP. These findings seem to give evidence that the association of ISDN and IABCP may really be effective in reducing and stabilizing the ECG extent of ischemic myocardial injury in pts with transmural AMI without left ventricular failure; however this aggressive therapy cannot have a widespread indication until more reliable criteria for evaluating infarct size are available and larger randomized clinical trials performed.

Assisted Circulation↗
PubMed1981

[Dynamic ECG, exercise stress testing and coronary arteriography for the diagnosis of ischaemic heart disease. A Bayesian analysis of probability (author's transl)].

In spite of great technological improvement in Ambulatory ECG Monitoring (AEM), there is still debate about its reliability in detecting ECG signs of myocardial ischemia and about the utility of AEM and Exercise Stress Testing (ET)--apart and/or in association--to predict Coronary Artery Disease (CAD). 50 consecutive male patients (pts) (mean age 51 +/- 69 years, 37 to 64 years) were studied for precordial chest pain. 17 had evidence of previous myocardial infarction. Resting ECG was normal in 21 pts and abnormal in 29; no pt received therapy during the examination period. ECG recordings were considered positive for ischemic ECG changes if there was greater than or equal to 1 mm of horizontal or down sloping ST-segment depression or ST-segment elevation of the same degree for greater than or equal to 0.08 sec in at least 15 consecutive beats; coronary arteriography was considered positive for significant CAD if any major vessel had greater than or equal to 75% luminal diameter narrowing. The percentage of false negative results was similar in AEM and ET (22.7% vs 22.2%); the false positives were few with both tests: 2 pts and 1 pt respectively; Bayesian probability (post-test likelihood for disease) calculated using the prevalence of CAD estimated from 2124 male pts who underwent coronary angiography in our Laboratory, for a given test result was very high: 97.1% +/- 1.3% (AEM), 98.6% +/- 1.1% (ET) and 98.1% +/- 1.1% (AEM & ET if concordant); post-test likelihood for CAD in a patient who did not show the given test result decreased to 67.8% +/- 1.3% (AEM), 60.9% +/- 1.1% (ET) and 52.1% +/- 1.1% (AEM & ET if concordant). The application of Bayes' theorem to these two non invasive tests improves the evaluation of patients with suspected CAD; the association of AEM and ET enhances the diagnostic accuracy.

Adult↗
PubMed1979

[Physical work capacity of the patient with myocardial infarction submitted to intensive rehabilitative training (author's transl)].

The Authors have examined two homogeneous groups of patients with myocardial infarction; one underwent (61 patient) to a rehabilitating training, the other underwent (42 patient) to a domiciliary physical program. Patients have been considered by means of bicycle ergometer test at 2, 4, 12 and 24 months from myocardial infarction. They have been taken into consideration clinical and Ecg factors and also, as an index of physical work capacity was considered the complete work developed, the VO2 max/Kg per min., the product B.P. x H. R. and the pulse O2. The average value of parameters have been statistically compared by means of the t of Student, analysis of variation x2, and the test of Kolmogorov-Smirnov; moreover the correlation with linear coefficient has been studied. Afterwards the many-varied discriminating analysis and the test F di Snedelor have been carried out just for the index of functionality. From the statistical analysis of the data considered it results an increase of the functional capacity and its maintenance long after in the group that underwent to the rehabilitating training. However, two years after, this increase of capacity did not result greater than that obtained, in the same period of time, by the group of patients who underwent to a domiciliary physical rehabilitating program. These considerations point out the necessity of keeping physical exercise indefinitely or at least of repeating it periodically. In that event they suggest the right time to programme further cycles of training.

Adult↗