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Biomedical subjects

E Grossi

Publications and source records attributed to E Grossi.

At least 55 records · Page 3Linked to original sources
PubMed1989

Treatment of reversible chronic airways obstruction with doxofylline compared with slow-release theophylline: a double-blind, randomized, multicentre trial.

A multicentre, double-blind, randomized trial was carried out in 11 Italian Pneumologic Clinics to investigate the therapeutic efficacy and tolerability of doxofylline compared with slow-release theophylline in 139 patients (86 males, 53 females) aged 17-77 years suffering from reversible chronic airways obstruction. The two groups of 69 patients on doxofylline and 70 patients on theophylline did not differ in their baseline clinical and functional parameters. After one week of wash-out, the two drugs were administered orally at a dose of 400 mg twice daily of doxofylline and 300 mg twice daily of theophylline. The treatment and follow-up lasted 28 days. Inhaled salbutamol on demand was allowed in the wash-out week and throughout the trial. The average serum levels at day 14 and 28 were: doxofylline 7.5 and 8.5 micrograms/ml; theophylline 10.4 and 7.95 micrograms/ml respectively. Both drugs significantly increased spirometric parameters (p less than 0.001 for all tests) and significantly reduced salbutamol consumption (p less than 0.001 for both drugs). Doxofylline was better tolerated than theophylline considering either the number of unwanted side-effects: (doxofylline 12; theophylline 37) or number of drop-outs due to side-effects (doxofylline 5; theophylline 10). From these results doxofylline seemed to be a good alternative to theophylline in the treatment of reversible chronic airway obstruction in view of its better safety profile.

Adolescent↗
PubMed1989

Doxofylline, an adenosine-nonblocking xanthine, does not induce cardiostimulant effects.

Doxofylline (ANSIMAR) is a new adenosine-nonblocking anti-asthmatic drug with potent bronchodilator activity that does not display the typical extrapulmonary side effects of theophylline--a potent adenosine antagonist. The cardiac activity of doxofilline and theophylline was investigated in guinea pig right and left atrial preparations and in anestetized cat. In spontaneously beating right atria doxofylline slightly increased the atrial rate only at 0.3 mM, while theophylline induced a concentration-dependent positive chronotropic effect starting at 0.03 mM. The contractile force of electrically stimulated left atria was affected by doxofylline starting at 0.3 mM. Theophylline induced the same effect already at 0.03 mM. In the anesthetized cat, doxofylline (1-30 mg/kg.i.v.) did not affect the diastolic blood pressure, but the heart rate increased slightly at a dose of 30 mg/kg i.v. On the contrary, theophylline induced a marked dose-dependent hypotensive and positive chronotropic effect. Doxofylline was 10 times less potent that theophylline is its ability to antagonize the cardiodepressant activity induced by adenosine in isolated guinea pig atria. The pharmacodynamic differences between doxofylline and theophylline may bring new insights to the understanding of the mechanisms underlying the positive chronotropic effects of xanthines, and the functional importance of endogenous adenosine. Additionally, the lack of cardiostimulant effects makes doxofylline highly suitable for the treatment of chronic obstructive lung disease particularly in combination with beta 2-adrenergic agonists.

Adenosine↗
PubMed1988

Evidence for a prostaglandin-mediated bone resorptive mechanism in subjects with fasting hypercalciuria.

This study was performed to assess whether treatment with prostaglandin synthesis inhibitors decreases calcium excretion in patients with idiopathic hypercalciuria. Nineteen hypercalciuric (12 with fasting hypercalciuria (FH), 7 with nonfasting hypercalciuria (NFH) and 8 control non-hypercalciuric stone formers were treated with sodium diclofenac, 50 mg t.i.d. for 2 weeks. After a washout phase, 7 FH patients received 200 mg/day of sulindac (a nonsteroidal antiinflammatory agent (NSAID) inactive on renal prostaglandin synthetase) for 14 more days. Diclofenac reduced urine calcium excretion in subjects with idiopathic hypercalciuria with either normal or elevated fasting urinary calcium (from 387 +/- 26 to 240 +/- 23 mg/day, P less than 0.001; and from 370 +/- 39 to 246 +/- 40 mg/day, P less than 0.05, respectively), whereas it was ineffective in normocalciuric stone formers. Similar antihypercalciuric effectiveness was exerted by sulindac in the seven FH patients. The antihypercalciuric action exerted by diclofenac in subjects with FH was associated with a significant increment in serum PTH (48 +/- 4 vs, 70 +/- 9 pmol/liter, P less than 0.05), whereas in NFH subjects, the antihypercalciuric effect of diclofenac on NFH was not associated with a change in parathyroid activity. Since the major effect of NSAIDs is to decrease prostaglandin synthesis, these data suggest that prostaglandins may play a pathogenetic role in idiopathic hypercalciuria. Furthermore, they suggest that PTH is suppressed in patients with FH, possibly due to stimulation of prostaglandin-mediated bone resorption process.

Adolescent↗
PubMed1987

Anesthetic and supportive management during experimental pulsatile flow perfusion studies in calves.

The purpose of this study was to determine the factors influencing successful experimental cardiopulmonary bypass studies using pulsatile flow perfusion and the medications and methodology necessary to produce successful bypass in calves. In six calves showing no cardiopulmonary pathology prior to bypass procedures, successful anesthesia and surgical intervention was accomplished. Animals were maintained on 5 hours of pulsatile flow bypass perfusion. Successful recovery from the procedures was accomplished. In two calves with pre-existing pulmonary pathology, anesthetic and surgical intervention was accomplished with the utilization of extensive anesthetic management and cardiac supportive medications until the animals could be initiated into 5 hours of pulsatile flow bypass perfusion, in spite of major pulmonary dysfunction. In these two animals, attempts to resuscitate upon termination of pulsatile flow perfusion were unsuccessful due to pre-existing excessive lesions in the lungs. This study shows a contrast between complete success of a pulsatile flow system in normal subjects versus the ultimate failure in experimental animals with pre-existing pulmonary pathology. The inability of experimental calves with a diseased lung to resume spontaneous cardiopulmonary function after the challenges of thoracic intervention indicates the unsuitability of animals with marked pre-existing pulmonary disease status for use in cardiopulmonary bypass studies.

Anesthesia, General↗
PubMed1986

Antipyretic therapy in ICU patients: evaluation of low dose diclofenac sodium.

The antipyretic effect of diclofenac sodium 0.2 mg/kg i.v. was studied prospectively in 10 ICU patients. Patients with renal failure and hypovolaemia were excluded from the study; mean basal temperature (measured by the pulmonary artery thermistor) was 38.92 degrees C +/- 0.413 SD. In 9 of the 10 patients, the temperature fell by more than 0.5 degrees C within 1 h of administration of the drug. A minimum mean of 37.80 degrees C +/- 0.636 SD was obtained by the hour 3; the temperature then remained lower than basal throughout the entire observation period (6 h). Changes in haemodynamics and oxygen consumption were consistent with the reduction in temperature. Changes in renal function were transient and did not require any therapeutic intervention. We conclude that the proposed dosage (in the selected patient population) constitutes effective antipyretic treatment devoid of major side effects.

Body Temperature↗
PubMed1986

Correlation between subjective labour pain and uterine contractions: a clinical study.

Fifteen primiparous women underwent tocography during the second phase of the first stage of labour in order to evaluate the main characteristics of their uterine contractions (intensity, duration and pattern). At the end of each contraction, for a total of about 8 contractions per woman and an overall total of 125 tocographic curves, each woman was asked to make a subjective evaluation of the pain felt during that contraction using a 10 cm visual analogue scale (VAS). All the tocographic curves corresponding to the contractions studied were elaborated mathematically to determine the peak (intensity), base (duration) and area under the curve (AUC). Lastly, correlations between the mathematical parameters of the curves and corresponding VAS scores were sought. In the population a general positive correlation between the 3 main parameters of tocographic curves and the VAS score was demonstrated; the AUC and the peak tended to be better correlated with VAS than duration. Within-subject comparison showed the existence of a significant correlation with VAS score in 12/15 women as far as peaks are concerned, in 10/15 as far as AUC is concerned and in 0/15 women as regards duration. The findings support the concept that perceived labour pain depends in most of the women on the intensity and pattern of the uterine contractions. The possible clinical and experimental applications of this finding are discussed.

Adult↗
PubMed1986

Use of carbamazepine in acute psychosis: a controlled study.

A randomized double-blind study was performed to compare the therapeutic effects of lithium and carbamazepine (CBZ) each administered in combination with chlorpromazine (CPZ) for 3 weeks in women with acute psychosis. Thirty patients were studied. The initial dose was 1200 mg/day for CBZ and 900 mg/day for lithium, and it was subsequently modified according to plasma levels and clinical indications. The dose of CPZ was free and depended on the severity of symptomatology. Both treatments produced a significant improvement in psychotic symptoms without significant differences between the treatment groups. Also, as regards tolerability no clinically relevant differences were found between the two groups. During the first week of treatment the CPZ dose required in the CBZ group was significantly lower than that administered to the lithium group, indicating that CBZ had a greater sedative action; however, this difference decreased as treatment continued. These results confirm that CBZ is a valid alternative to lithium in the treatment of acute psychosis.

Acute Disease↗
PubMed1986

Diclofenac sodium versus acetylsalicylic acid: a randomized study in febrile patients.

One hundred and twenty adult patients with high temperatures (greater than or equal to 38 degrees C) brought about by influenza viruses or other conditions were randomly treated with two different antipyretics: a) a 25 mg sodium diclofenac tablet (Novapirina) every 12 hours for 2 consecutive days; b) a 500 mg tablet of acetylsalicylic acid (Aspirin) every 8 hours for 2 consecutive days. Antipyretic action (assessed at 6 hours following the first administration) was found to be equally rapid and consistent in both cases but significantly longer-lasting in the Novapirina-treated group than the Aspirin-treated group (p less than 0.01). Mean temperature changes over the 48 hours of observation and the over-all judgement on the antipyretic effect expressed at the end of each day of treatment were similar for both groups and good in all cases. The antiphlogistic-painkilling properties of both drugs were found to be effective in improving the symptomatology accompanying the high temperature during the course of the bout of influenza. The effectiveness/tolerability ratio was found to be satisfactory for both groups: only one case of gastric intolerance to Novapirina was recorded and five cases of gastric intolerance to Aspirin.

Adult↗
PubMed1986

Strategy for treatment of acute evolving myocardial infarction with pulsatile left heart assist device. Can this modality increase survival and enhance myocardial salvage?

This article describes the technique of left heart bypass in the treatment of both experimental and clinical acute myocardial infarction. A new technique of closed-chest percutaneous left heart bypass that can be used in patients with acute evolving myocardial infarction and cardiogenic shock is also described.

Acute Disease↗
PubMed1985

Effect of maprotiline on pentagastrin-stimulated acid secretion in man.

We have studied the effect of maprotiline, an antidepressant with a strong pronoradrenergic effect, on human gastric secretion. Twelve subjects (nine men and three women) entered the study; six had an active duodenal ulcer, and six were healthy volunteers. Each patient underwent two experiments with an interval of at least 48 h. In a randomized double-blind order, each patient received maprotiline or placebo intravenously during intravenous stimulation with pentagastrin (2 micrograms/kg/h). Thirty minutes after basal collection, pentagastrin was administered for 180 min by constant intravenous infusion. After 60 min placebo or maprotiline (1 mg/kg/h) was added to the intravenous infusion from the 60th to 120th min; thereafter 2 mg/kg/h were infused until the 180th min. Maprotiline infusion (2 mg/kg/h) inhibited significantly stimulated acid secretion in comparison with placebo in duodenal ulcer patients but not in healthy volunteers.

Adult↗
PubMed1984

Ionization with diclofenac sodium in rheumatic disorders: a double-blind placebo-controlled trial.

A double-blind randomized study was performed to compare ionization with diclofenac sodium (150 mg) and ionization with saline solution in two groups of patients with scapulo-humeral periarthritis or elbow epicondylitis. The subjects of both groups were treated with 20 ionization sessions each lasting 30 minutes during a 1-month period. There was a significantly greater improvement in pain at rest, pain on pressure, pain on movement and joint swelling in the eleven patients treated with diclofenac compared with the thirteen placebo-treated patients, but no significant differences between the two treatments as regards functional impairment. However, placebo treatment produced a slight but significant improvement in pain on pressure, pain on movement and functional impairment. Further studies are needed to assess the relative role of the current and of autosuggestion in saline ionization response since both have well-known therapeutic effects on chronic rheumatic pain.

Adult↗
PubMed1984

Double-blind placebo-controlled trial of baclofen, alone and in combination, in patients undergoing voluntary abortion.

This study evaluated the analgesic efficacy of baclofen in relation to specific pain stimuli in 83 women (27 nulliparas and 56 multiparas) undergoing voluntary abortion (clamping of the cervix and dilatation and curettage). The patient population was divided into five treatment groups as follows: group 1, placebo; group 2, baclofen, 0.3 mg/kg, administered intravenously (IV); group 3, baclofen, 0.6 mg/kg IV; group 4, baclofen, 0.3 mg/kg IV, and fentanyl, 1.5 mg IV; and group 5, baclofen, 0.3 mg/kg IV, and diazepam, 5 mg given orally and 5 mg IV. In each case the surgical intervention was started using analgesia only. When the first sensation of pain was recorded, a paracervical anesthetic block was performed to provide pain relief for completion of the operation. The results showed that baclofen had significantly better analgesic properties than did placebo, with no important side effects. Its analgesic action seemed to be dose-dependent, since better results were obtained with the higher dose. The analgesic effect was slightly potentiated when baclofen was combined with fentanyl, but not when it was combined with diazepam. Factors independent of the pain stimuli and drugs used--the most important being parity--influenced the results.

Abortion, Induced↗