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Biomedical subjects

G Tognoni

Publications and source records attributed to G Tognoni.

At least 289 records · Page 16Linked to original sources
PubMed1976

Regional distribution of diazepam and its metabolites in the brain of cat after chronic treatment.

Repeated administration of diazepam leads to remarkable accumulation of N-desmethyldiazepam in white matter structures and in subcortical areas such as thalamus, hypothalamus, and hypophysis. Diazepam and the hydroxylated metabolites were present in lesser amounts. The distribution pattern of diazepam and N-desmethyldiazepam offers a rationale for its efficacy in inhibiting seizures spreading and for the lack of effect on primary foci discharges.

Animals↗
PubMed1976

An integrated approach for the evaluation of psychotropic drug in man. I. Studies on amphetamine. Relationship between drug levels and psychophysiological measurements.

Following an integrated approach based on the contemporary recording of drug plasma levels, central (CNS) and peripheral responses and performance tests, the effects of two different amphetamine formulations were evaluated in healthy volunteers. Interesting relationships were observed between amphetamine initial rate of entry into the blood stream and both incidence of side effects (S.E.) and rise in arterial blood pressure. Minimal thresholds for CNS (5 ng/ml) and peripheral (20 ng/ml) effects could also be determined. It appeared also that the personality of the subject may have some bearing on both incidence of side effects and performance. The described methodology seems valuable in valuating psychotropic drug effects in man through a comprehensive integrated approach.

Adult↗
PubMed1975

Placental transfer to diazepam and its disposition in the newborn.

Diazepam (DZ) placental transfer in pregnant women at term, following single or repeated drug administration by various routes, was evaluated. DZ and its metabolite N-demethyldiazepam (NDZ) were constantly present in umbilical cord plasma at concentrations comparable to the mother's shortly after drug administration. N-methyloxazepam (MOX) was detected in cord plasma only in a limited number of cases following chronic DZ treatment. Postmortem analysis of fetal tissue concentrations showed accumulation of NDZ in heart and lungs. Differences in NDZ concentrations between venous cord (VC) and arterial cord (AC) plasms suggest metabolic degradation of DZ in the fetus. The DZ apparent plasma half-life in the newborn was found to be longer (31 plus or minus 2 hr) than previously observed in infants and children. The low drug clearance appears to be linked to reduced urinary excretion of hydroxylated metabolites, suggesting limited capability to dispose of DZ in the newborn.

Administration, Oral↗
PubMed1975

N-desmethyldiazepam and amylobarbitone sodium as hypnotics in anxious patients. Plasma levels, clinical efficacy and residual effects.

Drug plasma levels of N-desmethyldiazepam (10 and 20 mg/day given at night) and amylobarbitone sodium (200 mg/day given at night) were determined in 45 patients after 1 and 7 days of treatment together with estimates of hypnotic and residual effects. No relationships were found between clinical rati ngs of hypnotic effect and drug plasma levels, while significant correlations were observed between some performance taska and drug plasma concentrations of amylobarbitone sodium, and of the higher dose of N-desmethyldiazepam.

Adult↗
PubMed1975

Pharmacokinetics of N-demethyldiazepam in patients suffering from insomnia and treated with nortriptyline.

1 Hospitalized patients suffering from insomnia were treated with N-demethyldiazepam (30 mg p.o.) for 10 days, while continuing treatment with nortriptyline (75 or 100 mg daily). 2 Clinical evaluation performed by objective rating scales showed a positive therapeutic effect. No correlation was found however between drug plasma levels and clinical efficacy. A high inter-individual variability was observed. 3 In three cases the N-demethyldiazepam disappearance curve showed a biexponential decay, with a slow first component followed by a faster one. 4 Compared with diazepam the tested drug has a longer plasma apparent half-life and a lower relative clearance.

Adult↗
PubMedDate not supplied

The case of GISSI in changing the attitudes and practice of Italian cardiologists.

This report first describes the efficiency achieved by a large scale clinical trial (GISSI), which is widely recognized as having made an important contribution to the therapy of AMI, and second emphasizes how a comprehensive research project based upon an innovative clinical trial methodology can influence the attitude and the scientific productivity of a professional community operating within a national health system. To understand the methodology of GISSI, one must appreciate both the cultural and institutional setting in which the first GISSI trial took place as well as the strong economic and scientific expectation surrounding the second GISSI trial.

Attitude of Health Personnel↗
PubMedDate not supplied

Risk factors for lower limb complications in diabetic patients. The Italian Study Group for the Implementation of the St. Vincent Declaration.

Diabetic lower extremity complications may be influenced by a number of factors, including those related to the interaction between patients and the health-care system. Our objective is to identify risk factors for the development of lower limb complications, by looking for classical clinical variables and those related to quality of care. A case-control study was carried out between December 1993 and June 1994 by interviewing 348 patients with lower-limb diabetic complications and 1050 controls enrolled from 35 diabetes outpatient clinics and 49 general practitioner's offices in Italy. Among sociodemographic characteristics associated with increased risk of lower limb complications were male gender [odds ratio (OR) = 2.5, confidence interval (CI) 1.6-3.9], age between 50 and 70 years as opposed to younger than 50 (OR = 3.6, CI 2.1-6.3) and being single as opposed to married (OR = 1.4, CI 1.1-1.8). Among clinical variables, treatment with insulin for IDDM and NIDDM patients was an important predictor of lower extremity complications compared to NIDDM patients not being treated with insulin. Cardio-cerebrovascular disease and presence of diabetic neuropathy were associated with a higher risk of being a case (OR = 1.4, CI 1.2-1.8 and OR = 3.0, CI 2.1-4.2, respectively). Patients who needed help to reach the health facility before the onset of the complications and those who did not attend health facilities regularly were more liable to develop complications (OR = 1.5, CI 1.1-2.2 and OR = 2.0, CI 1.3-3.0, respectively). Patients who had never received educational intervention had a threefold risk of being a case as compared to those who received health information regularly. The study identifies factors most likely to be related to adverse outcome and permits to discriminate between avoidable and unavoidable factors.

Adult↗
PubMedDate not supplied

Prognosis of epilepsy in newly referred patients: a multicenter prospective study. Collaborative Group for the Study of Epilepsy.

A multicenter prospective study was initiated at the time of first antiepileptic treatment for afebrile seizures with 283 unselected patients in Italy. Each patient started with monotherapy at standard daily doses. Data were collected at admission, at scheduled 6-month exams, and at unscheduled exams and included age, sex, general profile of the disease, and treatment. Prognosis of epilepsy was evaluated by actuarial methods using first seizure relapse after onset of treatment to indicate unfavorable prognosis. In addition, a maximum interval of complete seizure control was calculated and related to length of follow-up in order to grade the severity of the disease (defined as mild, moderate, or severe). The average length of follow-up was 21.6 months (range 2-40). Seizure relapse occurred in 52% of cases during follow-up (36% by 3 months, 43% by 6 months, and 49% by 12 months). A larger number of seizures before therapy and the presence of combined seizure patterns were the variables most commonly associated with relapse. In general, epilepsy was mild in 65% of the cases, moderate in 28%, and severe in 7%. The earlier the first relapse the higher the risk of developing more severe disease. A larger number of seizures before treatment, combined seizure types, earlier age at onset, and prolonged disease duration (1 month to 1 year) seemed to be more frequently associated with the development of moderate-to-severe epilepsy.

Actuarial Analysis↗
PubMedDate not supplied

Cholesterol reduction and stroke occurrence: an overview of randomized clinical trials.

We performed a meta-analysis of randomized clinical trials of more than 6 months duration to describe how fatal and nonfatal strokes are related to cholesterol lowering and to the type of intervention. A total of 41 individual trials including approximately 80,000 subjects and followed for an average of about 4 years were included in the overview. There was a 16% (95% CI, 7-25%) reduction in risk of stroke among treated patients compared to control patients (test for heterogeneity, p = 0.76). When trials that used different interventions were separately examined, a significant reduction in stroke occurrence was observed only for those using statins as active treatment (risk reduction 23%; 95% CI 13-33%). A variance-weighted regression analysis of the logarithmic odds ratios for stroke incidence against the percentage of cholesterol reduction indicated that a reduction of fatal and nonfatal stroke can be obtained for a cholesterol reduction of 9% (95% CI 6.8-13.6%). The combined data of primary and secondary prevention trials indicate that a large reduction of blood cholesterol, achievable with statin drugs, can reduce the incidence of stroke.

Anticholesteremic Agents↗