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Biomedical subjects

G Grassi

Publications and source records attributed to G Grassi.

At least 199 records · Page 11Linked to original sources
PubMed1983

Unwanted symptoms in depressed patients treated with viloxazine: an algorithm for identification of illness-related symptoms.

Ninety-six depressed outpatients from 5 centres were given viloxazine 200-400 mg/day. The treatment produced significant clinical improvement as evaluated by the Hamilton Rating Scale for Depression. Thirteen patients dropped-out because of possible side effects. Many untoward symptoms were described by all the patients. To distinguish between illness-related symptoms (IRSs) and potential side effect symptoms (SESs) a new approach was taken, using an algorithm that provides a decision strategy based on the time course both of the symptom and the illness. By this procedure, 90 of the 187 claimed untoward symptoms were identified as IRSs. Of the 97 potential SESs, only 36 were spontaneously volunteered, and the remaining 61 symptoms were elicited on specific questioning. Whenever possible, volunteered potential SESs were assessed to determine the relationship between the drug treatment and the adverse reaction. It was found that only a few instances of gastric disturbance and exacerbation of anxiety were probably viloxazine-related.

Adult↗
PubMed1983

Transesophageal pacing for prognostic evaluation of preexcitation syndrome and assessment of protective therapy.

An esophageal lead was used to perform decremental atrial pacing and elective induction of atrial fibrillation (AF) in 5 patients with the Wolff-Parkinson-White (W-P-W) syndrome before and after amiodarone therapy. In the control state, 1:1 atrioventricular (AV) conduction over the accessory pathway ranged from 220 to 260 ms (mean 232). The shortest R-R interval during AF ranged from 190 to 210 ms (mean 198). The ventricular rate ranged from 175 to 212 beats/min (mean 196). After amiodarone therapy, the shortest cycle length with 1:1 AV conduction increased in all patients, ranging from 290 to 540 ms (mean 370); during AF, no preexcited beat was present in 2 patients, whereas the minimal preexcited R-R interval in the remaining 3 was 290, 240, and 370 ms, respectively. The ventricular response during AF decreased in all patients. Thus, esophageal pacing is a useful method for identifying patients at risk with the W-P-W syndrome and for assessing appropriate management in individual patients. Amiodarone provides protection against life-threatening arrhythmias in these patients.

Adolescent↗
PubMed1983

Mechanisms of antihypertensive action of beta-adrenergic blocking drugs: evidence against potentiation of baroreflexes.

A possibility that can be advanced to explain the antihypertensive effect of beta-blocking drugs is that they act through the baroreflex control of the cardiovascular system. In 38 essential hypertensive patients we measured 1) The lengthening and shortening in R-R interval caused by stimulation or deactivation of arterial baroreceptors (vasoactive drug technique); 2) The fall and rise in blood pressure caused by stimulation and deactivation of carotid baroreceptors (neck chamber); 3) The rise in forearm vascular resistance caused by deactivation of cardiopulmonary receptors (lower body suction). The study was made before and after 6-10 days' administration of nadolol (80-360 mg once a day) or acebutolol (200-600 mg t.i.d.). Nadolol and acebutolol similarly reduced blood pressure and heart rate. Either drug increased heart rate responses to arterial baroreceptor manipulation but the increase fell short of statistical significance. Blood pressure and vasomotor responses to carotid baroreceptor and cardiopulmonary receptor manipulation were also not significantly modified by beta blockade. The baroreceptor control of heart rate and blood pressure showed a modification, however, insofar as a resetting towards the lower blood pressure values occurred. These findings demonstrate that arterial baroreceptor and cardiopulmonary receptor control of circulation is not potentiated by beta-blocking drugs, and that therefore this mechanism cannot account for their antihypertensive effect. The resetting of the baroreflex that occurs during beta blockade may, however, contribute to maintain the hypotension obtained.

Adrenergic beta-Antagonists↗
PubMed1983

Long term results in traumatic dislocation of the hip in children.

The long term results of 14 cases of traumatic dislocation of the hip in children are reviewed. The follow-up period was from 10 to 30 years, which in all but 2 cases involved attaining skeletal maturity. The following observations are recorded. The lesion can be produced by comparatively minor trauma; the prognosis is more benign than in adults; prolonged restriction of weight bearing does not play any significant role in the development of complications, particularly in children under the age of 6. Late complications are essentially related to the severity of the initial trauma than to early or late weight bearing.

Adolescent↗
PubMed1982

Modification of arterial baroreflexes by captopril in essential hypertension.

Captopril lowers blood pressure without increasing heart rate and plasma norepinephrine, which suggests that this drug may potentiate arterial baroreflexes. In eight subjects with untreated essential hypertension, blood pressure was monitored intraarterially and the effects of baroreceptor stimulation or deactivation were assessed by measuring (1) the slopes of the relations between increase or reduction in systolic pressure (intravenous phenylephrine or nitroglycerin) and the resulting lengthening or shortening in R-R interval, and (2) the increase or decrease in mean arterial pressure induced by increasing and decreasing carotid transmural pressure (neck chamber). The measurements were made before and after a hypotensive oral dose of captopril (50 mg). Before captopril, the slopes of the R-R interval changes with increase and reduction in systolic pressure were 8 and 4 ms/mm Hg, respectively. The slopes of the mean arterial pressure changes with increase and reduction in carotid transmural pressure were 0.51 and 0.40 mm Hg, respectively. After captopril, the responses to baroreceptor stimulation were unaltered but those to baroreceptor deactivation were augmented. The pressor and heart rate responses to hand-grip and cold exposure were unchanged by captopril. Administration of captopril is accompanied by a baroreflex potentiation which involves the lower portion of the stimulus-response curve of the reflex. This phenomenon (which may originate at the afferent baroreceptor fibers or centrally) may avoid a reduction in the tonic baroreflex influence during captopril-induced hypotension, thus contributing to the hemodynamic effects of the drug.

Adult↗
PubMed1982

Blood pressure response to labetalol in twice and three times daily administration during a 24-hour period.

1 The anti-hypertensive effect of labetalol given twice or three times daily was evaluated in ambulant subjects with essential hypertension by recording blood pressure directly for 24 h before and after 15 d of labetalol administration (daily dose 600-1800 mg). 2 Labetalol reduced 24 h systolic and diastolic blood pressures by about 20%. The reduction was evident throughout the whole 24 h period, although it was less marked during sleep. The hypotensive effect was similar when the drug was given twice or three times daily. 3 The 24 h heart rate was reduced during labetalol treatment. However, this effect was less marked than the hypotensive effect and was not present in all subjects. 4 There was a reduction in the standard deviations of blood pressure and heart rate values. However, in neither case was the coefficient of variation altered, indicating that labetalol did not have any significant effect on the shape of the 24 h blood pressure measurements.

Adult↗
PubMed1981

[Does the number of treated rejection episodes in the first transplantation influence the survival of the patient with kidney re-transplantation?].

The records of 77 patients who received a second kidney transplant at the Surgery Department of Addenbrooke's Hospital, Cambridge, have been re-examined to assess the influence of the number of rejection episodes treated during the first transplant on the survival of the second. 61 of the 77 retransplanted patients lost their first kidney for immunological reasons. 6 did not present any treated episode of rejection, 45 one episode only and in 10 greater than 1 episode was treated during the first transplant. P less than 0.05 from 1 to 5 years as regards survival of the second transplants in patients whose first kidney did not present treated rejection episodes by comparison with those presenting 1 or greater than 1. No significant difference was noted in patient survival in the various groups under examination. On the basis of the results obtained, it is concluded that, in addition to the cause of failure and duration of the first transplant, the number of treated rejection episodes during the first transplant should be considered as a critical parameter for better selection of the most suitable candidates for receiving a second transplant.

Graft Rejection↗
PubMed1981

[Influence of ischemia time on the long-term survival of kidney re-transplants].

The influence of warm and cold ischemia times on the long term survival of subsequent renal allografts has been evaluated. The retrospective study has involved 77 patients who in the year period 1966-1977 were submitted to 86 subsequent renal allografts at the Department of Surgery of the Addenbrooke's Hospital-Cambridge. Although a trend to do better was found in the group of allografts having warm ischemia time greater than 45' and less than 90' and cold ischemia time greater than 200' and less than 400', no statistical difference resulted in the survival curves among the various groups at examination.

Body Temperature↗
PubMed1981

Arrhythmia control by cardiac stimulation.

Cardiac programmed stimulation in the control of tachyarrhythmias offers encouraging prospectives. We describe two devices which utilize radiofrequency as a means of synchronization and stimulation and can be triggered by the patient himself when tachycardia occurs. In addition we introduce a third anti-tachycardia device, completely automatic, which can be used in cardiologic departments. The first device described permits critical stimulation and can be programmed to deliver a single or double synchronized impulse. The second device, which utilizes the same implanted unit and electrode as used for critical stimulation, when activated searches the tachycardia interruption zone by scanning. The third device, based on the same principles, has a rate discriminator that activates the scanning stimulation. We treated 12 patients: 8 suffering from paroxysmal supraventricular tachycardia (4 with Wolff--Parkinson--White syndrome, 2 with intranodal reentry, 2 with brady--tachy syndrome); 2 patients with ventricular recurrent tachycardia; 1 with atrial flutter; and another with iterative junctional tachycardia. The follow-up varied for every patient from 6 yr to 3 mth.

Arrhythmias, Cardiac↗
PubMed1981

[Long-term electrical stimulation of tachycardias: control by ambulatory electrocardiographic monitoring (author's transl)].

The Authors suggest a new method, elaborated by their own, for long-term antiarrhythmic stimulation. They used ambulatory electrocardiography in order to evaluate the results. It consists of a radio frequency device for synchronization and stimulation, and allows the scanning stimulation of all the cycle of tachycardia, with automatic search for the zone of interruption. The stimulatory is carried by the patient, who must set it in motion at the onset of the tachycardia. Preliminary results show the efficacy of the method; Holter monitoring seems to be the best guide to the development of a satisfactory implantable automatic tachycardia-terminating pacemaker.

Ambulatory Care↗