Biomedical subjects
Publications and source records attributed to P Innocenti.
The Authors describe a case of mucoid anal carcinoma occurring in a perianal fistula. Surgical treatment was an abdomino-perineal resection (Miles' operation). On the basis of their experience and of the results reported in the literature, the Authors discuss the clinical and histological aspects of this association.
The comparative adequacy was investigated of a nonionic contrast medium (iohexol) versus the ionic contrast medium usually employed in hysterosalpingography. The contrast radiologic features and the radiodiagnostic possibilities of both cm are definitely good. The nonionic contrast medium diffuses quickly and causes the uterine cavity to expand less than ionic contrast media do, thus allowing a better depiction of mucosal and/or parietal pathology. Moreover, nonionic cm allows tubal patency and peritoneal diffusion to be clearly demonstrated, particularly in uncertain cases. As compared to ionic cm, Iohexol did not cause any side effects, except for a mild discomfort. Our results lead us to suggest the use of nonionic contrast medium as the routine contrast medium in hysterosalpingography.
UNLABELLED: In an open non-comparative clinical study, 19 patients with spontaneous angina pectoris admitted to hospital with attacks lasting greater than 10 minutes, unresponsive to nitrate and/or calcium antagonist treatment, at least 2 ECG readings of raised (greater than or equal to 1.5 mm) or lowered (greater than or equal to 1 mm) ST segment not attributable to earlier AMI in the same area, were treated after the interruption of conventional treatment (mean 47 +/- 34.2 min) with 2 million IU endovenous UK in 15 mins followed by 1 million IU endovenous UK in 60 mins. Sixty minutes after UK administration was terminated, they were given a bolus of 5000 IU calcium heparin, followed by 1000 IU per hour for 2 days. Coronary angiography (Judkins technique) was performed before the start of UK treatment and 15, 30, 45, 60 and 75 minutes into it. RESULTS: Basal coronarography showed only "multiple organic stenosis" in 5 out of the 19 patients, a more complex situation suggestive of thrombi in the coronary arteries in 14. Subsequent angiographies (mean 30 mins later) revealed coronarographic improvement in 11 out of the 19 (58%), or 11 out of 14 (78.5%) if we exclude those with simple stenosis. Angina attacks were significantly lower in the 8 days after UK treatment than in the week before it in terms of number (4 v. 1; p less than 0.01), global severity (7 v. 1.5; p less than 0.01) and global duration (45 v. 4.25 min; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
To extend our previous findings that a low-Na/high-K salt (S) reduces BP in hospitalized patients, a multicenter study was performed. After a placebo period during which patients were informed by written instruction how to avoid only foods with a high Na content, 143 out-patients (84 males and 59 females, mean age 50.7 years, range 28-69) with DBP greater than or equal to 95 mm Hg randomly received for 4 weeks either metoprolol (M) 200 mg SR qd (67 patients), or S, 2 g bid to add to foods (76 patients). At the end of this period patients with DBP still greater than 90 mm Hg combined the two treatments for a further 4 weeks. Mean blood pressure (mm Hg), HR (bpm), 24-hrs urinary Na and K excretion were measured fortnightly. In comparison to pretreatment values MBP was significantly (P less than 0.01) reduced by both treatments, although to a greater extent in the M group already at the second week, without any further decrement thereafter. In the S group MBP decreased by 4.4 mm Hg and 27/76 patients were responders (DBP less than or equal to 90 mm Hg), while in the M group it was reduced by 9.0 mm Hg and 28/67 patients were responders. In the S group urinary Na excretion was significantly (P less than 0.01) lower than in the M group, and this difference was present until the end of period 1.(ABSTRACT TRUNCATED AT 250 WORDS)
There is an increased incidence of gallstones in patients who have undergone Billroth II (BII) gastrectomy for duodenal ulcer. To explore the mechanisms underlying this, we examined changes in gallbladder volume induced by a meal and by intravenous administration of cerulein, in 13 BII patients and in 13 normal subjects. Gallbladder volume was measured by real-time ultrasonography. In the fasting state, gallbladder volumes were significantly larger in BII patients than in controls. The percent decrease in gallbladder volume after the meal was significantly less and maximum volume reduction observed throughout the study occurred sooner in BII patients than in controls. In contrast, the kinetics and magnitude of the reduction in gallbladder volume induced by cerulein were similar in the two groups. These findings suggest that the altered gallbladder response to a meal is due to impaired postprandial stimulation of gallbladder following BII gastrojejunostomy.
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It has been established that angiotensin II stimulation may limit the antihypertensive potential of diuretic therapy in some patients. It is less clear, however, whether renin-angiotensin II stimulation is the cause of the flat blood pressure dose-response relationship to diuretics. To investigate this, 75 out-patients with essential hypertension were treated with chlorthalidone 12.5, 25 or 50 mg o.d. for 3 weeks, in a double-blind, placebo controlled cross-over study. Chlorthalidone significantly reduced blood pressure in all the groups, a plateau being reached at 25 mg o.d. Similarly, plasma renin activity was increased by each dose level of chlorthalidone, but it showed a different trend, being increased to a comparable extent at 12.5 mg and 25 mg o.d., and still higher at 50 mg o.d. Thus, greater stimulation of renin was coincident with the levelling of the blood pressure response to chlorthalidone. However no significant correlation was found between interindividual plasma renin activity and change in blood pressure, either in the entire series, or in each treatment subset. The data suggest overall that renin stimulation may influence the characteristic dose-hypotensive response relationship to diuretic agents in antihypertensive therapy, but it is unlikely that measurement of individual plasma renin activity will provide an useful guide to the optimal dose of a diuretic agents.
In this study we compared the antihypertensive efficacy and tolerability of captopril at 25 mg twice daily, hydrochlorothiazide (HCTZ), 12.5 mg twice daily and placebo in a multicentre, double-blind, randomized study that included 152 essential hypertensive patients (77 males, 75 females, 87 WHO stage I, 65 WHO stage II, aged 69 +/- 4 years, mean +/- s.d.). Supine and standing blood pressure were similarly reduced by captopril and HCTZ (P less than 0.01 for both compared with placebo). The heart rate did not change. Captopril (25-30 mg twice daily) and HCTZ (12.5 mg twice daily), alone or in combination, maintained their antihypertensive effect during a 24-week single-blind follow-up study. During the follow-up, diastolic blood pressure remained less than 100 mmHg in seven essential hypertensives on placebo, in 45 on captopril and in 25 on HCTZ. Side effects were observed in seven essential hypertensives during placebo (treatment withdrawn in two), in eight during HCTZ and in three during captopril. Serum potassium was reduced (P less than 0.05) and uric acid was increased (P less than 0.01) only during HCTZ. We conclude that captopril and HCTZ have similar antihypertensive efficacy in the elderly; however, captopril appears to be better tolerated.
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The authors describe a controlled clinical study in which rifamycin SV 250 mg intramuscularly and topical b.i.d. was compared to intramuscular neuramide b.i.d. plus, where necessary, other drugs (antibiotics, polivitamins, analgesics, etc.) for the treatment of two groups of thirty randomly selected patients suffering from herpes zoster. In all patients the symptoms were controlled by both treatments but statistical tests revealed that rifamycin SV was able to heal pain (p less than 0.05), vesicles, crusts and burning sensation (p less than 0.1) faster than neuramide. Furthermore, by the seventh day of therapy, the authors found that rifamycin SV reduced the intensity of both pain and erythema (p less than 0.01 for pain; p less than 0.05 for erythema) more than neuramide.
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