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Biomedical subjects

P Botti

Publications and source records attributed to P Botti.

33 records · Page 2Linked to original sources

Clinical experiences with Ro 15-1788 (anexate) in benzodiazepine and mixed-drug overdoses.

Benzodiazepine overdose is the most common of admission to the Toxicological Unit of the University of Florence. The aim of this study has been to evaluate the efficiency of Ro 15-1788 in benzodiazepine and mixed drug overdoses. The administration of Ro 15-1788 was followed by a quick reversal of central nervous system depression and was more effective in benzodiazepine overdoses than in mixed drug overdoses. The dose was titrated individually and the range 2-10 mg was effective according to the conditions of the patient. In some cases, the comatose state relapsed; further administration of Ro 15-1788 again promptly reversed the condition. On awakening, two patients displayed anxiety and restlessness.

Adult↗

Biological markers and therapeutic outcome in alcoholic disease: a twelve-year survey.

The early diagnosis and evaluation of the biological consequences of alcohol abuse are reviewed in a population of 401 chronic alcoholics admitted to our Toxicological Unit from January 1973 to the end of December 1984; selected cases were treated with disulfiram implantation. The results of the study indicate that anemia with increased globular volume of erythrocytes, elevated serum gamma-glutamyl-transferase activity, increased postprandial cholalemia, and increased elimination of pentane in the breath can be considered suitable markers for the early diagnosis of alcohol abuse. Disulfiram implantation significantly prolonged the abstinence duration in the treated patients.

Adult↗

Clinical findings and follow-up evaluation of an outbreak of mushroom poisoning--survey of Amanita phalloides poisoning.

One hundred and sixty cases of mushroom poisoning during the period July-November 1981 are reported. The survey details 116 observations of short incubation syndromes and 44 cases of delayed syndrome, identified as Amanita Phalloides poisoning. Of the latter, 40 patients were adult (mean age 46 years, range 20-77; 18 females and 22 males) and 4 were children (less than or equal to 12 years old; 3 females and 1 male). All the patients with Amanita Phalloides poisoning were treated according to a therapeutic protocol, based on the infusion of high doses of penicillin G, administration of dexamethasone and thioctic acid, careful correction of water and electrolyte unbalance. The severity of the disease varied in the population of 44 patients: 4 patients died (2 females, 10 and 77 years old; 2 males, 56 and 64 years old); 26 patients were discharged from the hospital as clinically cured; 14 were discharged with persistently abnormal levels of transaminases and they were advised of a follow-up evaluation. The average length of stay in hospital was 2 weeks. Of the patients followed-up, 6 were symptom-free after 6 months, with normal transaminase values and a normal histopathological picture of liver biopsy specimens. In the remaining patients, there was no normalization of transaminase values and liver biopsy specimens showed a picture of chronic active hepatitis. These patients displayed abnormal immunological tests, with presence of immune complexes and of anti-smooth muscle autoantibodies. The results indicate that Amanita Phalloides poisoning represents a threat not only in the high mortality acute phase, but also in the development of chronic active hepatitis in some survivors.

Adolescent↗

[Alcoholic cardiomyopathy in the preclinical stage: non-invasive clinico-instrumental research study on 112 chronic alcoholics].

112 consecutive asymptomatic patients who assumed alcohol in excess (1-2 g/kg/die) for 5 years or more were admitted to our hospital for detoxication. They were examined both clinically and with chest x-rays, ecg, phonocardiography, external pulse recording, and M-mode/2-D echocardiography to detect myocardial involvement. Heart disease not related to alcohol abuse was found in 6 cases. In the remaining 106/112 patients electrocardiographic abnormalities (aspecific ST-T changes, left bundle branch block, intraventricular conduction defects, left ventricular strain pattern and atrial fibrillation) were present in 18 per cent of cases. PEP, LVET intervals and PEP/LVET, were calculated only in 39/106 patients and did not differ significantly from the control group. The echocardiographic study showed hypokinesis and left ventricular dilatation in 9/106 patients. In other 5 cases echocardiographic findings were at upper limits of normal for left ventricular dimension and motility. Therefore in 13 per cent of cases a dilated cardiomyopathy was revealed by the echocardiographic study. In 6 of these 13/106 patients ecg was either normal or showed only aspecific ST-T changes. Echocardiography failed to confirm augmented left ventricular thickness and mass as reported in asymptomatic alcoholic patients in the literature. Probably several factors (different interval of time between the interruption of the alcoholic abuse and the time of examination, the quantity of alcohol in excess and the echocardiographic technique) may influence the results of such studies. The present report nevertheless points out to the validity of the echocardiographic study in the detection of subclinical myocardial involvement in alcoholic patients and should be performed in such cases.

Adult↗

Amanita poisoning: a clinical-histopathological study of 64 cases of intoxication.

In the last few years new and effective therapeutic schedules have been employed in the treatment of patients intoxicated by mushrooms of the genus Amanita. As a result, the survival rate has considerably increased and clinical-histopathological correlation studies, such as the present one, have become feasible. The fate of these patients was once wrongly considered to be either complete recovery (rarely) or death (frequently). According to the results of the present study, Amanita intoxication can also progress to chronic liver damage. This latter evolution of the disease seems to depend on the severity of the acute phase of the intoxication, as clinical, laboratory and biopsy findings of liver alteration testify. The correct evaluation of evolving liver damage involves histopathological investigations, which should be performed 6 months after the acute episode, in those patients who overcome a moderate to severe acute intoxication.

Amanita↗

VIP-, substance P- and met-enkephalin-immunoreactive innervation of the human gastroduodenal mucosa and Brunner's glands.

VIP-, substance P- and met-enkephalin-containing innervation of the human gastroduodenal mucosa and Brunner's glands was studied by immunocytochemistry on whole mount tissue preparations. A dense VIP-containing nerve supply was found around fundic and pyloric glands, while the few and scattered substance P-immunoreactive fibres tended to run across the full thickness of the gastric mucosa. In the duodenum, both VIP and substance P were present in a striking nerve network in the villi as well as in the muscularis mucosae and around blood vessels. Both peptides were also immunostained in nerve bundles and neuronal perikarya between the lobules of Brunner's glands, while only very few fibres reached the proximity of acinar cells. Met-enkephalin-immunoreactivity was detected in a small number of nerve fibres, virtually confined to the basal parts of the mucosa and to the duodenal submucous plexus.

Duodenum↗

A-V block by an overdose of Clonidine.

The case of a young addict woman, chronically treated with Clonidine, in whom an overdose of the drug determined transient S-A and A-V conduction disturbances is reported. Such effects have been attributed to vagal hyperactivity and must be kept in mind when the drug is administered to patient of old age, with cardiac disease, or in association with digitalis. The treatment of choice is represented by forced diuresis induced either by osmotic diuretics of furosemide.

Adult↗

Overall evaluation of treatment modalities for heroin addiction in a toxicology unit.

A survey of treatment results is presented, using a variety of guidelines for the therapy of different features of heroin addiction in a toxicology unit. Data on 3,211 inpatients under treatment from 1972 are analyzed separately, as well as the follow-up status of 1,262 outpatients who were enrolled in a methadone treatment program. The results are discussed in terms of reliability of the programs and their risk-benefit ratios for the community.

Clonidine↗

The use of crown ethers in peptide chemistry-V. Solid-phase synthesis of peptides by the fragment condensation approach using crown ethers as non-covalent protecting groups.

We have previously described the conditions by which peptide synthesis by the solid-phase fragment condensation approach can be carried out using crown ethers as non-covalent protection for the N alpha-amino group. Here we demonstrate that the procedure can be extended to large, partially protected peptide fragments possessing free Lys and/or Arg residues. The first step was to ensure that complex formation on the side chain of amino acids was not detrimental to the methodology and exhibited the same solubility and coupling properties as N alpha-complexed peptides. Thus, a model hexapeptide was synthesized using Fmoc chemistry containing Lys and Arg residues, which, when complexed with 18-Crown-6, was readily soluble in DCM and coupled quantitatively to a resin-bound tetrapeptide. Two tripeptides were then prepared, one containing a free Ser residue, the other free Tyr, to examine the possible occurrence of side reactions. After coupling using standard conditions only the former tripeptide exhibited the formation of the O-acylation by-product (5%). Another model hexapeptide containing Lys, Tyr, Ser and Asp protected with a TFA-stable adamantyl group was complexed with 18-Crown-6 and coupled to the resin-bound tetrapeptide with near quantitative yield. Extending the length of the peptide to 21 and 40 residues, which represent sequences Gly52 to Leu72 (21-mer) and Pro33 to Leu72 (40-mer) from Rattus norvegicus chaperonin 10 protein, respectively, resulted in partially protected fragments that were readily soluble in water, thus enabling purification by RP-HPLC. Complexation with 18-Crown-6 gave two highly soluble products that coupled to resin-board tetramer with 68% and 50% coupling efficiencies for the 21-mer and 40-mer, respectively. Treatment with 1% DIEA solutions followed by acidolytic cleavage and purification of the major product confirmed that the correct product has been formed, when analysed by amino acid analysis and ESI-MS. These results served to extend the methodology of non-covalent protection of large partially protected peptide fragments for the stepwise fragment condensation of polypeptides.

Amino Acids↗

[Type 2 diabetic nephropathy: clinical course and prevention proposals 2004].

The first clinical evidence of nephropathy is the appearance of low, but abnormal, albumin levels in the urine (>30 mg/day or 20 mg/min), microalbuminuria. Without specific interventions, approximately 80% of type 1 diabetics have their urinary albumin excretion increase at a rate of 10-20%/yr to the stage of overt nephropathy or clinical albuminuria (>300 mg/24h or >200 mg/min) over 10-15 yrs, developing hypertension along the way. Approximately 30% of individuals with type 2 diabetes are found to have microalbuminuria or overt nephropathy shortly after the diagnosis of their illness, because diabetes is actually present for many years previously and because the presence of albuminuria can depend on other concomitant nephropathies, as shown by biopsy studies. Without specific intervention, 20-40% of type 2 diabetic patients with microalbuminuria progress to overt nephropathy, but 20 yrs after onset only 20% progress to end-stage renal failure (ESRD). The rates of decline in glomerular filtration rate (GFR) are highly variable from one individual to another, but they may not be substantially different between patients with type 1 and type 2 diabetes. As therapies and interventions for coronary artery disease continue to improve, more elderly type 2 diabetes patients can be expected to survive long enough to develop renal failure. The recently published Italian Society of Nephrology (SIN) guidelines for diagnosis and therapy of diabetic nephropathy present the route for the best strategies in prevention and therapy, from earlier onset to advanced ESRD.

Diabetes Mellitus, Type 2↗