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Biomedical subjects

E Marchesi

Publications and source records attributed to E Marchesi.

At least 55 records · Page 3Linked to original sources

Comparison of the effects of loratadine and astemizole in the treatment of children with seasonal allergic rhinoconjunctivitis.

The efficacy and safety of a once-daily dose of loratadine 10 mg (5 mg in patients whose body weight was less than or equal to 30 kg) and astemizole 2 mg/10 kg body weight o.d. were compared in a 14-day third-party blind study. Forty-one children (30 boys and 11 girls, aged 6-14 years) with seasonal allergic rhinoconjunctivitis entered the study. The pollen count was monitored throughout the study. A significant improvement (p less than 0.01) in allergy symptoms was observed from the third day for both drugs; there was no significant difference between drugs, although loratadine led to a greater reduction in symptoms. In the astemizole group, the apparently rapid onset of drug action might by explained by reduced pollen exposure. Therapeutic response was excellent/good in 83.3% and 58.8% of the loratadine and astemizole groups, respectively. The results reported by the patients/parents were similar. Nine of the children on astemizole and four children on loratadine complained of side effects; three patients in the astemizole group were withdrawn from treatment because of adverse effects. No abnormal changes in lab values were observed in either group.

Adolescent↗

[Chronic suppurative osteomyelitis. Report of a case].

After a short introduction about the most important clinical and radiologic features of chronic osteomyelitis of the jaw, the Authors describe the case of a patient affected by the above mentioned pathology since 1984. The understatement of this pathology had led to an involvement of the inferior alveolar nerve. Finally, the Authors emphasize the importance of a combined therapy, both pharmacological and surgical, to eliminate the infection.

Facial Pain↗

Double-blind comparison of perindopril and captopril in hypertension. Effects on left ventricular morphology and function.

Using digitized M-mode echocardiograms, we compared, in a double-blind study, the effects of 4 to 8 mg perindopril given once daily and 25 to 50 mg captopril given twice daily on the left ventricle (LV) in 20 hypertensive patients. Both treatments significantly (P less than .001) lowered blood pressure, reducing systemic vascular resistances. After 3 months both drugs induced a comparable percentage of reduction in LV mass, with an increase in the peak rate of LV relaxation and no changes in the peak rate of LV contraction. Our results demonstrate that perindopril once daily is an effective antihypertensive agent; it is also able, like captopril, to induce regression of LV hypertrophy, with improvement in diastolic performance and no deterioration in ventricular systolic function.

Adult↗

Protective effect of loratadine on specific conjunctival provocation test.

The protective effect of loratadine (anti-H1 antagonist) on clinical and cellular processes following the early phase of specific conjunctival provocation test was assessed in 20 patients affected by seasonal allergic rhinoconjunctivitis, in a double-blind, randomized, placebo-controlled, parallel-group study. Patients were randomly assigned to two treatment groups, each being given a single daily dose of loratadine 10 mg or placebo, for 7 days, out of pollen season. Pretreatment with Loratadine resulted in a significant higher allergen threshold dose than placebo (p less than 0.01). Patients treated with loratadine experienced a significant reduction (p less than 0.01) in conjunctival symptom severity as compared with placebo, following conjunctival challenge. Finally, the number of inflammatory cells was lower in the loratadine-treated patients compared to the placebo group (p less than 0.01). In conclusion, loratadine exerts a significant protective effect on the early phase cellular and clinical events of conjunctival reaction induced by allergen challenge in atopic patients.

Adolescent↗

[The variability of the heart rate, arterial pressure and peripheral circulation as the indices of autonomic control in essential hypertension].

In recent years the influence of autonomic nervous system on cardiac rhythm and blood pressure has been increasingly studied by analysis of cardiovascular fluctuations, particularly in diabetic and normal persons under various physiologic conditions, while still few data exist on essential hypertension. To characterize the autonomic cardiovascular control in essential hypertension we studied 22 untreated hypertensives, diagnosed within 1 year (mean age 43 +/- 2 years, mean +/- SEM) and 16 age-matched normotensives. Recordings of RR interval, breathing activity, noninvasive blood pressure (Finapres) and skin arteriolar flow (infrared photoplethysmogram) were obtained while in supine position and after sympathetic activation induced by passive transition to upright posture (tilting table). Autoregressive power spectral analysis was then carried out, and low- (0.03-0.15 Hz, LF) and high-frequency fluctuations (0.15-0.35 Hz, HF) were measured. LF and HF have been considered as markers of sympathetic and parasympathetic activity on the heart, respectively, and as markers of sympathetic and mechanic chest activity on the circulation, respectively. In supine position both cardiac and vascular variability were similar in both hypertensive and normotensive groups. After tilting however the increase in the sympathetic component of cardiac variability was blunted in hypertensives with respect to normotensives (hypertensives LFnu from 43.6 +/- 4.7 nu to 59.4 +/- 5.1 nu, p less than 0.005; normotensives LFnu from 36.9 +/- 3.3 nu to 83.4 +/- 2.6 nu, p less than 0.001), the increase in LFnu being statistically (p less than 0.001) reduced in the hypertensive subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Metabolic effects of the combination of captopril and hydrochlorothiazide in hypertensive subjects.

The medium-term (16 weeks) effects of the combination of captopril and hydrochlorothiazide (HCTZ) on some metabolic indexes, particularly on plasma lipoproteins, were evaluated in 20 mild to moderate hypertensive outpatients. After a 4-week wash-out period, the subjects were given one tablet of a new commercially available fixed combination once/daily (i.e., captopril 50 mg + HCTZ 25 mg). The dose could be titrated to a maximum of one tablet twice daily according to individual blood pressure responses. Both systolic and diastolic blood pressure significantly decreased at week 4 and showed a further decrease thereafter; the rate of responders (diastolic blood pressure at or below 90 mm Hg at the end of the study) was very high (90%). The only metabolic change was a small though significant increase in HDL cholesterol (P less than .05), almost entirely due to an increase in the denser HDL3 subfraction. The atherogenic fractions, namely total cholesterol, LDL cholesterol, and apoprotein B, showed no significant changes. Plasma triglycerides underwent a transient increase at week 8 (P less than .05) but thereafter fell. Plasma glucose, creatinine, uric acid, and potassium were unchanged. The fixed combination of captopril and HCTZ seems highly effective in lowering blood pressure and seems devoid of untoward metabolic effects. Its overall impact on the coronary risk profile in hypertensive subjects seems therefore to be favorable.

Adult↗

[Loratadine and dexchlorpheniramine in the treatment of perennial allergic rhinitis in pediatric patients].

The use of loratadine was compared to dexchlorpheniramine in the treatment of children affected by perennial allergic rhinitis in order to assess its clinical efficacy and tolerability. Children were randomly assigned to two groups: 15 were treated with loratadine and 16 with dexchlorpheniramine. Loratadine was administered in a single daily dose of 5 mg (2.5 mg for children under 20 kg) and dexchlorpheniramine at a dose of 1 mg every 8 hours (0.5 mg for the youngest children). Clinical symptoms were recorded before and during the study using a score of 0.3 (from absent to severe). Symptoms were markedly reduced by both drugs. Eye burning was reduced more by loratadine (p less than 0.05) than the control drug. Rhinoscopic investigations revealed that both groups reacted favourably to the drugs used. Overall clinical assessment showed similar and revealed the good efficacy of both drugs. Tolerability was satisfactory and there were no signs of drowsiness. Hematological and hematochemical parameters showed no clinically significant changes and body weight remained constant. On the basis of these results, loratadine is preferable to dexchlorpheniramine thanks to its once-a-day dosing.

Age Factors↗

[Platelet adrenergic alpha receptors in hypertensive subjects undergoing treatment with calcium antagonists].

The effects of two different calcium-channel blocking agents on platelet alpha-2 adrenoceptors were studied in 18 mild to moderate hypertensive patients. The subjects were randomly assigned in a double blind fashion to treatment with either nifedipine 10 mg t.i.d. or tiapamil 300 b.i.d. for six weeks. Platelet alpha-2 receptors were studied before and following 6 weeks of treatment using radioligand binding assay (3H Rauwolscine). Both agents induced a reduction in alpha-2 receptors, which reached statistical significance only for nifedipine. Such a reduction may contribute to the antihypertensive effect of calcium-channel blocking drugs.

Adult↗

[Blood platelet alpha adrenergic receptors in congestive heart failure. Effects of ACE inhibition].

Platelet alpha-2-adrenergic receptor number and affinity were examined in 12 patients with class IV NYHA congestive heart failure (CHF) and 10 normal volunteers paired for age and sex. Platelet alpha-2-adrenergic receptor number is significantly decreased in CHF patients (178 +/- 18 fmol/mg prot. vs 282 +/- 21 fmol/mg prot. p less than 0.05). After Captopril treatment (6 weeks) alpha-2-receptor number increased but this increase was not statistically significant (236 +/- 28 fmol/mg prot.). This study supports the hypothesis that increased levels of circulating catecholamines in CHF lead to a decrease in platelet alpha-2-adrenoreceptors. Improved cardiac function following administration of Captopril could lead to a withdrawal of sympathetic tone. Captopril may also interact with sympathetic nervous function.

Aged↗

[Alclometasone dipropionate (Legederm) for the treatment of steroid-sensitive dermatoses in the elderly].

This is a randomized single blind parallel comparison of alclometasone dipropionate cream 0.1% vs hydrocortisone butyrrate in 39 geriatric patients (greater than 60 years old) with steroid sensible skin diseases. The regimen consisted of dosing patients with two applications of the two drugs every day for 4 weeks. Follow-up evaluations have been done weekly, and subjective and objective clinical symptoms, adherence to the study protocol, evolution of the disease, onset of adverse reactions including atrophy have been recorded. Furthermore possible side-effects on hypophysis-adrenal axis have been monitored in baseline conditions, after 7 days and at the end of therapy. In most patients bioptic skin patterns for histomorphometric examination have been drawn before and after therapy to be evaluated by a blind examinator. Alclometasone has reduced initial skin lesions by 82.2%, the extent as hydrocortisone butyrrate. In five patients the complete clearance of the disease has been obtained. Study drugs have been tolerated well by all patients, nor clinical signs of atrophy have been observed. Fluctuations of blood cortisol levels ranged between the normal values. In patients treated with alclometasone histomorphometry revealed a better skin trophism than in patients treated with hydrocortisone butyrrate.

Aged↗

Effect of enalapril on left ventricular mass and performance in essential hypertension.

The effect of enalapril on left ventricular (LV) morphology and function was studied in 12 hypertensive patients. The subjects were evaluated after 2 weeks of placebo and after 4 months of treatment with enalapril (20 or 40 mg once daily), using M-mode digitized echocardiograms. The drug reduced arterial blood pressure in all patients. Systemic vascular resistance decreased significantly without changes in cardiac output and heart rate. No patient had significant side effects. After treatment LV mass decreased significantly (233 +/- 46 to 204 +/- 37 g, p less than 0.01); the reduction was due to a decrease in septal and posterior wall thickness, without changes in LV diameter. LV systolic function remained unchanged, whereas peak lengthening rate of LV dimension, an index of LV diastolic function, increased significantly (4.05 +/- 1.8 to 5.11 +/- 1.8 s-1, p less than 0.01). After treatment the basal inverse correlation between peak shortening rate and wall stress did not change, the inverse correlation between peak lengthening rate and wall stress became closer and the basal inverse correlation between peak lengthening rate and LV mass disappeared. In conclusion, antihypertensive treatment with enalapril led to a significant regression of LV hypertrophy associated with improvement in LV diastolic performance and no deterioration of LV systolic function.

Adult↗

Efficacy and safety of loratadine suspension in the treatment of children with allergic rhinitis.

The safety and efficacy of loratadine was compared with that of dexchlorpheniramine in children with allergic rhinitis. Twenty-one children received loratadine 0.11-0.24 mg/kg ideal body weight once daily and 19 dexchlorpheniramine 0.10-0.23 mg/kg every 8 h (0.30-0.69 mg/24 h) for 14 consecutive days. Both loratadine and dexchlorpheniramine were effective in reducing nasal and ocular symptoms in allergic children. Substantial improvement in allergy symptoms was observed at the first evaluation (day 3 of treatment) and was maintained for the study duration. No significant trend of abnormality in laboratory parameters was observed. Drowsiness was present only in the dexchlorpheniramine-treated group. Loratadine appears to be a simple, effective and safe therapy for seasonal allergic rhinitis.

Administration, Oral↗

A new procedure for large scale production and freezing of lymphokine activated killer (LAK) cells to be used in adoptive immunotherapy of cancer.

A new procedure for activation of peripheral blood lymphocytes (PBL) with recombinant interleukin 2 (rIL2) is described. PBL obtained by leukapheresis were subjected to NH4Cl (ACK) treatment to clear erythrocyte contamination; Ficoll separation was not performed. PBL were subsequently seeded in 10-floor multitrays (Cell FactoryTM, CF), gasified and incubated at 37 degrees C for 3-4 days in a humidified 5% CO2 atmosphere. This procedure achieved an activation (evaluated as cytotoxicity and proliferation) comparable with that obtained by culturing PBL in small flasks. Optimal activation of PBL was achieved in CF even in the presence of granulocyte contamination of up to 40%. It was also possible to freeze, thaw and recover most of the frozen cells and their cytotoxic activity. With this procedure therefore large quantities of lymphokine activated killer cells (LAK) can be easily produced to be used in adoptive immunotherapy trials.

Blood Preservation↗

[Clinical definition of asymptomatic abdominal masses].

Five patients with asymptomatic abdominal masses (abdominal leiomyosarcoma, giant hydronephrosis, renal cell carcinoma, squamous cell carcinoma of the lung metastatic to the adrenal gland, retroperitoneal non-Hodgkin's lymphoma) are reported. Non invasive investigations such as Echography and Computed Tomography, are very advantageous for the quick diagnosis of asymptomatic abdominal masses and for subsequent therapy.

Abdominal Neoplasms↗

[Central alpha 2-adrenergic receptors in the rat: effect of sodium in vitro].

Characteristics of the (3H) Rauwolscine binding were studied in homogenates of rat cerebral cortex, particularly in presence of NaCl. We had shown that (3H) Rauwolscine specifically bind the alpha 2-adrenoceptors. The Scatchard plot analysis had demonstrated 2 sites: a high affinity site (B 41,06 +/- 5,21 KD = 1,31 +/- 0,16) and a low affinity site (B = 203,41 +/- 13,37 KD = 11,62 +/- 0,55 nM). Incubation of cerebral cortex homogenates with NaCl 150 mM induced an increase (53,97 p less than 0.001) of the high affinity site density. These results indicate that (3H) Rauwolscine is a useful alpha 2-adrenoceptor ligand to study in animal models various central nervous system abnormalities or diseases induced by ion disorders.

Animals↗

Heparin for hemodialysis: practical guidelines for administration and monitoring.

Anticoagulation of extracorporeal circuit still represents a major problem for hemodialysis units. Uraemic patients are at risk of hemorrhages, so anticoagulant could increase such a risk. On the other hand clotting of extracorporeal circuit may complicate inadequate heparin administration or hemostatic activation by the foreign surfaces. In this article we propose a simple standard for heparin administration and monitoring which allows the theoretical best anticoagulation for extracorporeal circuit. Our data also indicate that the effect of our proposed schedule is not influenced by the type of membrane or dialyser used.

Adult↗