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Biomedical subjects

E Grossi

Publications and source records attributed to E Grossi.

At least 73 records · Page 4Linked to original sources

Regional intravenous guanethidine vs. stellate ganglion block in reflex sympathetic dystrophies: a randomized trial.

Regional intravenous guanethidine blocks and stellate ganglion blocks have been compared in a randomized trial. Nineteen patients, randomly allocated to two groups of therapy and exhibiting severe reflex sympathetic dystrophy following peripheral nerve lesions, have been treated. The performance of the intravenous guanethidine block is of longer duration and superior to stellate ganglion block, as regards some early pharmacological effects (skin temperatures and amplitude of plethysmographic waves recorded before blockade and 15 min, 60 min, 24 h, 48 h after institution of the block). In fact the intravenous guanethidine group shows a persistent and significant increase of the skin temperature and of the plethysmographic traces in the blocked side 24 h and 48 h after blockade in comparison with the patients treated with stellate ganglion block. Concerning the therapeutic effects (changes in pain scores and clinical signs--hyperpathia, allodynia, vasomotor disturbances, trophic changes, oedema and limited motion), recorded at the end of treatment and 1 month and 3 months follow-up, an intravenous guanethidine block carried out every 4 days up to a total of 4 blocks is comparable with a stellate ganglion block every day up to a total of 8 blocks. The results of this study show that regional sympathetic block with guanethidine is a good therapeutic tool in the treatment of reflex dystrophies, especially on account of its negligible risks and contraindications.

Adult↗

Intravenous maprotiline in severe and resistant primary depression: a double-blind comparison with clomipramine.

A double-blind, randomized trial is described which was designed to compare the clinical effect of 100 mg daily of maprotiline (Ludiomil) and of clomipramine (Anafranil) given by the intravenous route in forty hospitalized female patients with severe and resistant primary depression. Physicians' assessment of patients' progress was made following 5, 9 and 21 days of treatment. The response rates to maprotiline and clomipramine were not significantly different even if a greater number of patients responded to clomipramine. None of the demographic and clinical variables considered could be identified as factor predicting the response to maprotiline and to clomipramine, even if a trend for a preferential responsiveness to clomipramine in the older patients was observed.

Adolescent↗

Diclofenac sodium in ureteral colic: a double-blind comparison trial with placebo.

A randomized prospective double blind study of the analgesic effect of 75 mg intramuscular diclofenac sodium (Voltaren), a potent prostaglandin synthetase inhibitor, versus placebo (saline solution) was carried out in 131 consecutive patients with acute ureteral colic. Diclofenac provided complete relief of pain 25 minutes after the injection in 59% of the cases, while placebo provided relief in 29% (p less than 0.01). Forty patients in the placebo group and seventeen patients in the diclofenac group needed an open injection of 75 mg diclofenac intramuscularly after 25 minutes due to persistent pain. Fifty-four of the fifty-seven patients treated with an open injection of diclofenac achieved complete relief of pain after 30 minutes. There were no side-effects of the treatment.

Adult↗

Treatment of acute alcohol withdrawal syndrome with carbamazepine: a double-blind comparison with tiapride.

A double-blind, randomized trial is described which was designed to compare the clinical effect of 600 mg daily of carbamazepine (Tegretol) and of tiapride (Sereprile) in hospitalized patients with pre-delirium tremens. Physicians' assessment of patients' progress was made following 2, 4 and 7 days of treatment. Of the sixty patients admitted to the study, five dropped out for various reasons, leaving fifty-five patients who completed the study. Both drugs were effective in the treatment of alcohol withdrawal symptoms; no significant difference was found between the two treatments with respect to total symptoms, score and visual analogue scale assessment. Carbamazepine gave faster relief of symptoms and demonstrated a preferential action on symptoms like fear and hallucinations. No case of delirium tremens was observed in those patients who completed the trial.

Adult↗

Pirenzepine in duodenal ulcer. A multicentre double-blind controlled clinical trial, First of two parts.

Eighty-four patients with endoscopically-proved active duodenal ulcer were admitted to a multicentre double-blind trial with either pirenzepine tablets (25 mg three times per day for 1 week followed by 25 mg two times per day for 3 weeks) or placebo. Seventy-nine patients completed the trial, 44 treated with pirenzepine and 35 with placebo. After 4 weeks, complete healing had been achieved in 52% of the pirenzepine-treated patients and in 34% of the placebo-treated ones. Symptomatic responses were signigicantly better in those receiving pirenzepine than in those receiving placebo. In addition, the supplementary antacid consumption was significantly lesser in the pirenzepine group than in the placebo group. No important side-effects were observed in the two groups.

Adult↗

Effects of nabumetone, a new non-steroidal anti-inflammatory drug, on urinary prostaglandin excretion in man.

Nabumetone is a non-acidic pro-drug which, after absorption, is transformed by the liver into 6-methoxy-2-naphthylacetic acid (6-MNA), the active metabolite responsible for its anti-inflammatory activity. The urinary concentrations of 6-MNA are very low and its urinary metabolites are weak inhibitors of cyclo-oxygenase. For these reasons we hypothesized that nabumetone could spare renal cyclo-oxygenase products and, consequently, better preserve renal function unlike most other non-steroidal anti-inflammatory drugs (NSAIDs) which are known to cause an impairment of renal function, mostly related to inhibition of renal prostaglandin synthesis. We measured serum creatinine, creatinine clearance and the urinary excretion of stable prostaglandins (PG)E2 and 6-keto-PGF1 alpha, as a reflection of the renal production of PGE2 and PGI2, respectively, in 12 arthritic patients (5 males, 7 females) with normal creatinine clearance. Measurements were performed before and after a 2-week treatment with nabumetone (1 g day-1). 6-keto-PGF1 alpha and PGE2 were measured by specific radioimmunoassays (RIA) after organic solvent extraction and silicic acid column chromatography. The assay sensitivity to detect renal cyclo-oxygenase inhibition was independently verified by measuring urinary 6-keto-PGF1 alpha in normal subjects before and after aspirin and ibuprofen, known inhibitors of renal prostaglandins. At the end of treatment, serum levels of 6-MNA ranged between 24.5 and 122.4 mg 1-1, within the described therapeutic range for the drug. After nabumetone, no significant differences in the urinary excretion of the two prostaglandins with respect to baseline values were observed (for 6-keto-PGF1 alpha from 12.3 +/- 6.0 to 12.1 +/- 8.7 ng h-1, mean +/- S.D.; for PGE2 from 12.3 +/- 13.6 to 11.3 +/- 15.3 ng h-1). Also no changes in serum creatinine or creatinine clearance were observed. These results suggest that nabumetone does not significantly impair renal prostaglandin synthesis in patients with osteoarthritis.

Adult↗

Comparison of intravenously administered doxofylline and placebo for the treatment of severe acute airways obstruction.

This double-blind, randomized, placebo-controlled study investigated the therapeutic effects of a single dose of doxofylline, a methylxanthine derivative, in 10 patients aged 26-79 years. All patients had acute exacerbation of chronic obstructive airways disease partially reversible with salbutamol inhaler. Doxofylline was administered intravenously at a dose of 200 mg over 15 min on two different occasions separated by at least 24 h. Doxofylline increased forced expiratory volume in the first second of expiration compared with baseline as follows: +20% after 2 h (P less than 0.01); +31% after 4 h (P less than 0.01); and +13% after 6 h (NS). Changes produced by placebo at these times were -4.4%, -14% and -5% (all NS). The average differences between the groups were significant at all observation times. At the end of the observation period eight out of 10 patients given doxofylline and one out of 10 patients given placebo had improved clinically according to the patients' own opinion. Clinical tolerability of doxofylline proved to be good since no signs of local or general side-effects were observed in any of the patients treated.

Adult↗

Immunological patterns during regular intensive training in athletes: quantification and evaluation of a preventive pharmacological approach.

The effects of regular intensive exercise training on immune system homeostasis and the potential value of treatment with an immunostimulating agent were assessed in this randomized, double-blind, placebo-controlled, parallel-group study. A total of 60 athletes were studied over a 3-month period of regular intensive physical activity. After 1 and 3 months there were significant decreases in the immunoglobulin levels in the whole athlete population compared with baseline values. Specifically there were significant decreases in immunoglobulin M and immunoglobulin G (G1 and G2 subclasses). There was also a significant decrease in natural killer cells and a slight but significant increase in B and T lymphocytes. In the thymomodulin-treated group, unlike the placebo group, there was no significant decrease in the immunoglobulin G2 subclass and there was a significant increase in the T-helper cell subpopulation. The clinical relevance of these immunological findings should be evaluated in larger clinical and epidemiological studies.

Adolescent↗