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Biomedical subjects

G Ciprandi

Publications and source records attributed to G Ciprandi.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

The effect of aging on host defences. Implications for therapy.

Immunosenescence is a well known physiological phenomenon resulting from reduced efficiency of the immune system in the elderly. It has been studied both in animal models and in humans. In this review attention is focused on T cell responsiveness, since this cell type is both a marker of the immune response and one of the main targets of several drugs. For this latter reason, most studies of the effect of drugs on the immune system have been performed with reference to the effects on T lymphocytes. In the second part of the article experimental data concerning several drugs and drug classes [steroids, calcium antagonists, theophylline, histamine H1- and H2-receptor antagonists, sodium cromoglycate (cromolyn sodium), pirenzepine, rosaprostol, beta 2-mimetics, antibiotics and antibacterials] and immune responsiveness are reviewed. Lastly, the clinical perspectives of pharmacological treatment in aged subjects in relation to immunosenescence are evaluated.

Aged↗
PubMedDate not supplied

Nonsteroidal antiallergic treatments in allergic rhinitis.

Allergic rhinitis is characterized by an inflammatory reaction consequent to an initial IgE-dependent mast cell activation. The conventional treatment is mainly based on antihistamine and topical corticosteroid prescriptions. In this article the authors consider the antiallergic-antiinflammatory activity exerted by some nonsteroidal drugs or immunologic treatments. Clinical and experimental evidence demonstrates that these treatments are able to control allergic inflammation in patients with allergic rhinitis. In conclusion, treatment of allergic rhinitis may also be based on the prescription of nonsteroidal drugs with antiallergic activity.

Antibodies, Monoclonal↗
PubMedDate not supplied

Cardiovascular safety of second-generation antihistamines.

Reports of serious cardiac arrhythmia associated with some second-generation antihistamines have prompted concern for their prescription. This article reviews the nature of the adverse events reported and concludes that the blockade of potassium channels, particularly the subtype responsible for the rapid component of the delayed rectifier current (IKr), is largely responsible for such adverse cardiac events. Consequently, antihistamines with little or no interaction with these channels are expected to have the greatest safety margin. The main cardiac arrhythmia of concern is that of torsades de pointes, a potentially fatal phenomenon characterized by prolonged ventricular depolarization that manifests as a prolonged QT interval and polymorphic ventricular tachycardia, with twisting of the QRS complexes. Based on pre-clinical and clinical evidence, it appears that loratadine, cetirizine, and fexofenadine are safe from cardiac arrhythmia via the IKr channel, whereas astemizole and terfenadine have a propensity to cause ventricular tachyarrhythmias.

Animals↗
PubMedDate not supplied

Azelastine eye drops reduce conjunctival hyperresponsiveness to hyperosmolar glucose challenge in children with asymptomatic mite conjunctivitis.

Mite allergy is characterized by a continuous allergen exposure. Persistent inflammation is therefore always detectable; and during symptomless periods as well. It has been reported that mite allergic patients also present a nonspecific hyperreactivity to different stimuli, including hyperosmolar solution. Since azelastine was previously demonstrated to be able to reduce allergic inflammation, the aim of the study was to investigate the effects of the drug on nonspecific conjunctival hyperreactivity in mite-allergic patients. Twenty children with mite allergy were studied. A hyperosmolar conjunctival challenge was performed before and after azelastine eye drops or placebo treatment for a period of 2 weeks. It was found that patients treated with azelastine eye drops showed a significant reduction in nonspecific conjunctival hyperreactivity compared to the placebo group (p = 0.018). It was concluded that azelastine eye drops are able to reduce the nonspecific hyperreactivity present in subjects with mite allergy.

Adolescent↗
PubMedDate not supplied

Topical acetylsalicylic acid in the treatment of allergic pollinosic conjunctivitis.

The pharmacological treatment of allergic conjunctivitis includes the use of topical antiinflammatory drugs, i.e. steroids and NSAIDs (nonsteroidal antiinflammatory drugs), such as acetylsalicylic acid (ASA). However, steroids are not suitable in prolonged treatment, as well as in pollinosis in the Mediterranean area, because of their side effects. The present double-blind study evaluates the topical use of acetylsalicylic acid eye drops (1% solution) compared to placebo in the treatment of patients with seasonal allergic conjunctivitis during the period June-July 1990. The patients were randomized and treated with ASA eye drops or placebo eye drops, both applied as one drop in each eye q.i.d. for 14 days. The severity of symptoms was evaluated before and after treatment by the investigator and the patient. An overall judgement of therapeutic response was expressed independently by the patient and the investigator at the end of the treatment. The ASA-treated group improved significantly compared to the placebo-treated group. No serious side effects were observed. The results confirm the clinical efficacy and safety of topical ASA in the treatment of pollen-induced allergic conjunctivitis.

Adolescent↗
PubMedDate not supplied

Topical anti-inflammatory drugs in the treatment of allergic pollinosic conjunctivitis: a comparative double-blind study.

Anti-inflammatory drugs, i.e. glucocorticosteroids and NSAIDs (nonsteroidal anti-inflammatory drugs), are often included in the treatment of allergic conjunctivitis. The present study compares the clinical efficacy and safety of topical hydrocortisone, acetylsalicylic acid (ASA) and piroxicam compared to placebo. The trial, designed as a double-blind, randomized and parallel-group treatment, was carried out in a group of 40 patients suffering from seasonal allergic conjunctivitis due to Parietaria pollen, during the pollen season (June-July, 1990). Patients received hydrocortisone 0.1% solution, ASA 1% solution, piroxicam 0.5% solution or placebo as eye drops, all one drop in each eye q.i.d. for 14 days. The symptoms were evaluated at baseline and at the end of treatment by the clinician and by patients on a diary card. The hydrocortisone group showed a rapid and significant improvement during the first week of treatment, while ASA and piroxicam reduced symptomatology during the second week of treatment; this difference was statistically significant. At the end of the trial, the active drugs were comparable with regard to clinical efficacy. A statistically significant difference was observed between the active drugs and placebo, while no statistically significant difference was observed among the three drugs. No serious side-effects were observed. The results demonstrate the clinical efficacy of anti-inflammatory drugs in the treatment of pollen-induced allergic conjunctivitis; they also suggest the use of NSAIDs in long-term treatment, as their efficacy has been shown to be closely comparable to that of steroids, while avoiding the well-known side-effects of the latter in prolonged treatment.

Administration, Topical↗
PubMedDate not supplied

Inhaled tobramycin in children with acute bacterial rhinopharyngitis.

Antibiotic abuse for treating rhinopharyngitis induces the occurrence of resistant bacteria. As topical drugs might reduce this phenomenon, the aims of our study were to evaluate inhaled tobramycin in children with acute bacterial rhinopharyngitis and to compare it with oral amoxicillin/clavulanate. The trial was conducted as randomized, parallel group and double blind. Children, aged 3-6 years, with acute bacterial rhinopharyngitis were treated with 15 mg of aerosolized tobramycin (Group A) or 50 mg/Kg of amoxicillin/clavulanate (Group B) twice daily for 10 days. The following parameters were assessed: nasal obstruction, mucopurulent rhinorrhea, post-nasal drip, adenoidal hypertrophy, tympanic inflammation, tympanogram, rhinomanometry and cultures. Of 416 patients screened, 311 children (178 females and 133 males), median age 4.5 years, completed the study: 156 in Group A and 155 in Group B. Both treatments improved all parameters (p<0.01 for all). Intergroup analysis showed that inhaled tobramycin induced a better improvement versus amoxicillin/clavulanate concerning nasal obstruction (p<0.05), adenoidal hypertrophy (p<0.01), tympanic inflammation (p<0.01), rhinomanometry (p<0.01) and cultures (p<0.05). In conclusion, inhaled tobramycin may represent a valid treatment for acute bacterial rhinopharyngitis in children, as it is effective, safe, economic and simple to use.

Acute Disease↗
PubMedDate not supplied

[Phyllodes tumor of the breast (cystosarcoma phyllodes) (apropos 3 cases)].

There have been described three cases of the breast phyllodes tumour, i.e., fibroepithelial tumour, histologically both benign and on borderline, or expressively malignant (sarcoma). The mean age of patients concerned is of about 50 years old at the time of neoplasm diagnosis. If the surgical removal is incomplete, therein a large number of recurrences occurs. Diagnostic procedures are based on clinical examination (it is remarked the abnormal wideness of the tumour) as well as mammography, echography, needle biopsy. Surgical treatment is always based on large tumorectomy which results are sufficient in benign tumours. In malignant phylloides a total mastectomy is required without axillary lymphadenectomy owing to the hematic dissemination. Usually, after surgical treatment, survival rate seems better as compared to that of breast cancer.

Aged↗
PubMedDate not supplied

[Wilms' tumor or nephroblastoma].

Wilms' tumor represents one of the most frequent neoplastic disease of childhood: its prevalence is about 5-8 cases per million children aged less than 15 years, and its frequency ranks fourth among childhood solid tumors. Very marked improvement in the treatment of this lesion has occurred since 1942 with a 15% survival rate was reported. The modern approach to Wilms' tumor and its treatment based on the combination of surgery with chemo- and radiotherapy raised the survival rate to 80-95%, as shown by several cooperative studies performed in the United States and Europe. The nosographic, diagnostic and therapeutic aspects of the disease are reviewed and illustrated on the basis of the diagnostic imaging and anatomical features of cases treated by the authors.

Child↗
PubMedDate not supplied

Pirenzepine treatment in urticaria-angioedema syndrome caused by adverse reactions to foods.

An increased gastroenteric mucosal permeability is generally considered a pathophysiological mechanism in the urticaria-angioedema syndrome caused by adverse reactions to foods. Since pirenzepine, an antimuscarinic receptor drug, exerts a cytoprotective activity on digestive mucosa, the authors evaluated the clinical efficacy of pirenzepine and terfenadine (antihistamine), alone or associated, in the treatment of patients with urticaria-angioedema syndrome due to food allergy. Furthermore, additional endoscopy and biopsy studies were performed in order to provide experimental evidence about the cytoprotective activity of this treatment. The results of the present investigation confirm the clinical efficacy, with improvement of histological parameters, of pirenzepine treatment in adverse reactions to foods, as previously demonstrated by our group, and suggest further investigations on the functional mucosal impairment hypothesized in this pathological condition.

Adult↗
PubMedDate not supplied

Terfenadine (single or associated) treatment of adverse reactions to foods.

Six groups of patients (total 105), affected by cutaneous signs and symptoms related to food ingestion were studied with regards to the clinical efficacy of some pharmacologic treatments: blind placebo, terfenadine alone, terfenadine associated with pirenzepine or rosaprostol or ranitidine or famotidine. Pharmacologic treatment by terfenadine alone showed poor clinical results, similar to placebo, while the associations of terfenadine with both cytoprotective drugs and anti-H2 receptor antagonists revealed significant clinical improvement which is more evident in those patients treated with cytoprotective drugs combination than those who were treated with anti-H2 antagonists.

Adolescent↗
PubMedDate not supplied

Nedocromil sodium and the immune response.

Chromones are frequently employed in the treatment of allergic rhinoconjunctivitis and asthma. Following our recent investigations concerning the influence of some antiallergic drugs, such as cromoglycate sodium, steroids, oxatomide and ketotifen (H1 antihistamines), and theophylline, on the immune response, in the present study we analyzed the in vitro effects of a new chromone derivative, nedocromil, on the immune response. To this end, the proliferation of peripheral mononuclear cells (PMNCs) induced by mitogen (PHA) and by CD3, CD2 or CD28 monoclonal antibodies (MAbs) has been studied. Since the effects of nedocromil on immunological parameters are achieved at 10(-7) mol/l, in the experiments herein reported the drug was tested in the cultures at concentrations of 10(-8), 10(-7) and 10(-6) mol/l. Furthermore, the effect of nedocromil was evaluated on the surface expression of the following markers expressed by PMNCs upon activation: ICAM-1 (CD54), LFA-1 and alpha 1-acid glycoprotein (alpha 1-AGP). The results of the present investigation showed no effect of nedocromil on these immunological parameters. These data acquire clinical relevance when related to previous reports showing a depression of the immunological response exerted by other compounds, such as ketotifen, theophylline and steroids.

Adult↗
PubMedDate not supplied

[Intrapancreatic lipoma: a case report].

A rare case of asymptomatic pancreatic lipoma in an eleven-month-old child is presented. The abdominal mass was discovered occasionally during a grip episode. Preoperative tests proved the presence of a neoformation arising from the pancreas. It was multilobed, capsulated and located between colon transversus, spleen and stomach without infiltration of surrounding structures. The histological picture was that of a mature lipoma. The authors discuss the differential diagnosis versus other fat tumors.

Diagnosis, Differential↗
PubMedDate not supplied

Clobetasone treatment of allergic conjunctivitis: a comparative double blind study.

Glucocorticosteroids are often included in the treatment of allergic conjunctivitis. The present study compares the efficacy on clinical and cytological parameters and safety of topical clobetasone butyrate compared to placebo. The trial, designed as double blind, randomized and parallel group treatment, was carried out in 30 patients, suffering from seasonal allergic conjunctivitis due to Grass pollen, during the pollen season (June 1992). Patients received clobetasone butyrate 0.1% eye drops or placebo eye drops, two drops each eye, t.i.d. for 10 days. The clinical and cytological evidences were investigated on admission and at the end of treatment by clinicians and by patients on a dairy card. The steroid group showed a rapid and significant clinical improvement and at the end of the trial a statistically significant difference was evidenced between the active drug treated group and placebo treated group. No serious side effects were observed. The results show the clinical efficacy of clobetasone butyrate in the treatment of pollen-induced allergic conjunctivitis.

Adolescent↗