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Biomedical subjects

P Turco

Publications and source records attributed to P Turco.

68 records · Page 4Linked to original sources
PubMed1983

A new spirometric parameter in clinical pharmacology.

Several functional parameters can be used to define respiratory dysfunctions. Many of these variables provide specific information about particular physiopathologic phenomena, but they seldom provide a general overview of the ventilatory function. Nevertheless, both pharmacologic and epidemiologic research need functional parameters that precisely specify the respiratory defect. The new parameter we discuss takes into account the variations in volumes as related to flow variations: it is the product of two traditional spirometric parameters (FEV1 X MMEF). This value gives information on the patient's capacity to exhale air from the lungs for a fixed variation of intrathoracic pressure as well as data on the acceleration pattern of the expired volume in 1 s, hence the name, acceleration index (AI). AI was used to predict bronchodilation in two groups of patients with severe airway flow limitations. On the basis of our findings three conclusions can be drawn. This new spirometric parameter provides an inexpensive and rapid means of obtaining a highly sensitive definition of the patient's respiratory dysfunction which is useful in screening patients. Applied to patients with severe airways obstruction, AI can be used to immediately predict the reversibility of air flow limitation and then to define the limits of the activity of bronchodilators. Finally, a basal value of AI below 1.000 l/s-1 indicates the probable irreversibility of the airways obstruction, regardless of drug or route of administration. Such cases suggest a prevailing picture of emphysema rather than reversible bronchospasm.

Blood Gas Analysis↗
PubMed1983

Therapy for intercurrent respiratory infections in COLD patients: report on 200 patients.

Over the last 2 years we have applied a therapeutic regimen with simultaneous use of cephalexin and bromhexine in therapy for infective exacerbations of COLD patients. The results obtained are positive. Bacteriologic features, the modification of sputum and, where possible, behavior of hematologic parameters and blood gases were checked. This pharmacologic combination appears to be useful in pneumology, as it yields very good results in obstructive chronic bronchitis in a bacterial relapsing phase and with alveolar hypoventilation linked to massive presence of endoluminal mucus. With the exception of two patients, in whom nausea and gastric pyrosis were observed, we observed no toxic or side effects of any kind, not even in subjects treated for a long time.

Adolescent↗
PubMed1983

Reversibility prediction of chronic airways flow limitation by a new simple spirometric parameter.

A new simple spirometric parameter for predicting the reversibility of bronchial obstruction is evaluated in two homogeneous groups of severe COLD patients. By combining FEV1 and MMEF, this index is practically the product of the volume expired in 1s and the corresponding flow at 50% of FVC which characterizes the emptying pattern. The parameter provides a useful method for verifying the patient's responsiveness to beta 2-bronchodilator drugs. The bronchial flow limitation depends more on the airways obstruction present than on the characteristics of the drugs administered. A threshold level for the new parameter was defined (1000 l/s); beneath this value responsiveness to beta 2 drugs must be considered practically negligible.

Bronchodilator Agents↗
PubMed1982

[Mexiletine in the treatment of lidocaine-resistant ventricular tachycardia. Preliminary results].

Intravenous mexiletine (3 mg/Kg as bolus) was given to 7 patients with sustained ventricular tachycardia. Previous lidocaine administration in standard doses failed to suppress ventricular tachycardia. Mexiletine successfully suppressed the episodes of ventricular tachycardia in 6 of the 7 patients at a dose of 250 mg. Minimal non-cardiac toxicity occurred after mexiletine administration in the majority of patients. Mexiletine appears to be a promising alternative to lidocaine in the management of ventricular arrhythmias.

Drug Resistance↗
PubMedDate not supplied

Clinical use of controlled-release theophylline in chronic airways obstruction.

Daily general practice of theophylline dosing in chronic obstructive lung disease seems not strictly to follow therapeutic guidelines. To evaluate the efficacy of such an approach with regard to attaining therapeutic and safe plasma theophylline concentrations and clinical benefit, 103 patients with chronic obstructive lung disease were selected from the computerized database of a post-marketing survey. Dosing of theophylline was found to be independent of reference parameters, i.e. anthropometric data, age and clinical severity of the disease. Standard doses of 400 and/or 600 mg controlled-release theophylline, i.e. 7.9 mg/kg.day resulted in steady-state plasma concentrations of 10-20 micrograms/ml in 45.1% of patients and 5-10 micrograms/ml in 52.9% of cases. The increase in forced expiratory volume in 1 s at steady-state, evaluated by the percentage frequency distribution of changes from baseline was significant in all patients. In conclusion, not withstanding the daily therapeutic practice of controlled-release theophylline dosing and, at times, lower than optimal plasma levels, clinical and functional recovery was obtained in a large percentage of cases.

Adult↗
PubMedDate not supplied

Colorectal cancer screening by fecal occult blood testing: results of a population-based experience.

AIMS AND BACKGROUND: The study evaluated the results of an experimental screening protocol for colorectal cancer by fecal occult blood testing in a municipality of the Province of Florence. METHODS: A total of 15,235 subjects aged 50-70 years were invited to perform a 1-day immunochemical fecal occult blood testing without any dietary restrictions. All eligible subjects were sent a personal invitation letter, followed by a postal reminder to non-responders. Subjects with a negative stool test were advised to repeat screening after 2 years. Subjects with a positive screening test were invited to undergo full colonoscopy or a combination of left colonoscopy and a double contrast barium enema. RESULTS: A total of 6,418 subjects performed the screening test, with an overall compliance of 42.1%. A total of 268 compliers had positive test results. The positivity rate was 4.2%. Detection rate for cancer and for adenomas was 5.1% and 11.6%, respectively. The positive predictive value was 14.3% for cancer and 32.5% for adenoma. A higher compliance was recorded in subjects born in the province of Florence or living in the centre of the town, in married subjects, and in women. The best results in compliance were associated with the direct distribution of fecal occult blood testing kits by general practitioners to their outpatients. CONCLUSIONS: The study provides useful information about the efficiency and feasibility of a screening program for colorectal cancer using fecal occult blood testing. Compliance results confirm the importance of GP involvement in oncological screening.

Aged↗
PubMedDate not supplied

Prevalence of gastro-oesophageal reflux in asthmatics: an Italian study.

BACKGROUND: Gastro-oesophageal reflux is regarded as an asthma trigger, its prevalence, in asthma, still being uncertain. AIM: Purpose of the study was to assess the prevalence of gastro-oesophageal reflux in adult asthma patients. PATIENTS: A series of 37 asthmatics were recruited consecutively over 6 months. Subjects were: 19 atopic (5 males; 38.0 years +/- 4.1 SE), and 18 non-atopic asthmatics (5 males; 53.2 years +/- 4.3 SE). They were well matched for sex and basal lung function, whilst mean age was appreciably higher (p < 0.007) in non-atopic asthmatics. METHODS: Gastro-oesophageal reflux was detected by X-barium-oesophagram, endoscopy, and 24 h oesophago-gastric pH-monitoring. RESULTS: Gastro-oesophageal reflux was assessed in 78.9% of atopic, and in 83.3% of non-atopic asthmatics; the 24 h pH-monitoring was confirmed as the most sensitive method for gastro-oesophageal reflux detection. Hiatal hernia was found in 15.8% of atopic, and in 38.9% of non-atopic subjects. Respiratory symptoms always started long before gastro-oesophageal signs in atopic patients, while digestive symptoms came first (about 6 years) in 44.4% of non-atopic asthmatics. Oral theophylline was taken daily by 10.5% of atopic, and by 22.2% of non-atopic asthmatics. CONCLUSIONS: When non-atopic asthma starts at a later age without any family history of asthma, and/or after a long history of digestive symptoms, the role of gastro-oesophageal reflux can be strongly suspected.

Asthma↗
PubMedDate not supplied

Effect of inhaled beclomethasone dipropionate and budesonide dry powder on pulmonary function and serum eosinophil cationic protein in adult asthmatics.

The aim of this study was to determine whether the effects of inhaled beclomethasone dipropionate and budesonide dry powder on pulmonary function correlate with those on measurement of serum eosinophil cationic protein (sECP). Thirty-two asthmatic adults in a stable phase, treated daily with 1,000 micrograms beclomethasone dipropionate metered-dose inhaler, completed a 2-week wash-out period and were then randomized to receive a 200 micrograms/dose q.i.d. of either drug, over an 8-week period. Pulmonary function tests (FEV1, FVC, PEFR, FEF25-75% and MEF50) were measured at study entry, before and after every 2 weeks of treatment, while PEFR (morning and evening), symptom scores and salbutamol use PRN were recorded daily on a dairy card. sECP was measured at baseline and after 4 and 8 weeks of treatment. Safety variables included adverse reactions, morning serum cortisol and vital signs (heart rate and blood pressure). FEV1, FVC, PEFR, FEF25-75%, MEF50 and morning PEFR significantly increased (p < 0.05) over baseline in the beclomethasone group, while only FEV1 at week 6 and evening PEFR significantly increased (p < 0.05) in the budesonide group; no significant differences between groups were reported. sECP significantly decreased (p < 0.01) in the beclomethasone group at week 4 and 8 (p < 0.05 between groups). Evidence of statistically significant negative correlation between the FEV1 percent predicted and sECP was assessed at baseline (correlation coefficient r = -0.60, p < 0.05) in the total patient sample, and in the results, expressed as percent change over baseline, obtained at both week 4 and 8 (p < 0.01). A significant decrease in salbutamol use PRN, symptom score and number of daily bronchospasm attacks was also reported in the beclomethasone group (p < 0.05). No adverse reactions or relevant changes in morning cortisol and vital signs were reported in either group. It was concluded that sECP proved to be a reliable marker for monitoring inflammatory events in asthma; inhaled beclomethasone dipropionate dry powder was at least as effective as budesonide in improving lung function and the underlying asthma inflammation.

Administration, Inhalation↗
PubMedDate not supplied

[Proteiform syndrome (Proteus syndrome). Skin manifestations in a recently observed case].

The case of a 4-year-old female affected by partial gigantism of the feet, syndactyly and polydactyly, partial right hemihypertrophy of buttock and lower limb, warty hyperpigmented nevus and vulvar lipoma is described. The Authors discuss about the Proteus syndrome, pointing out its rarity, the polymorphism and the problems of differential diagnosis with the Klippel-Trenaunay-Weber syndrome and with other congenital hamartomatous disorders.

Abnormalities, Multiple↗
PubMedDate not supplied

Serum eosinophil cationic protein and bronchial hyperresponsiveness to hypoosmolar challenge in naive atopic asthmatics.

Inhaled nonisotonic solutions (e.g., ultrasonically nebulized distilled water, UNDW) are sensitive bronchoconstrictive agents in asthmatics, their suggested mechanism of action being the release of mediators from some inflammatory cells. Studies assessing the relationship between degree of bronchial hyperresponsiveness to UNDW and plasma levels of eosinophilic markers are not available to date. Fourteen asymptomatic, nonsmoking, naive asthmatics (8 males, aged 18 to 45; mean basal FEV1 = 93.8% predicted +/- 1.7 SE), monosensitized to Dermatophagoides pteronyssinus, and twelve normal subjects (9 males, aged 19 to 40, mean basal FEV1 = 93.3% predicted +/- 1.4 SE) entered the study after informed consent. Each subject performed the UNDW challenge while the transcutaneous pO2 (PtcO2) was monitored. Serum eosinophil cationic protein (ECP) was measured together with blood eosinophils 60 min before UNDW. The bronchial response was expressed as FEV1 and PtcO2% drop from baseline, as assessed 10 min following UNDW. Mean blood eosinophils were 3.4% total leukocytes +/- 0.3 SE in normal subjects and 7.9% total leukocytes +/- 0.4 SE in asthmatics (p < 0.001). Mean serum ECP was 4.6 micrograms/l +/- 0.6 SE in normal subjects and 22.4 micrograms/l +/- 1.3 SE in asthmatics (p < 0.001). Mean FEV1 drop was 2.1% +/- 1.1 SE in normal subjects and 24.2% +/- 1.1 SE in asthmatics; the corresponding mean PtcO2% drop was 3.6 +/- 0.7 SE in normal subjects and 28.6 +/- 1.4 SE in asthmatics. Serum ECP was found to be related to blood eosinophils (r = 0.7, p = 0.003); despite the eosinophils, serum ECP proved to be related to a drop in both FEV1 and PtcO2, atr = 0.6 (p = 0.024) and r = 0.7 (p = 0.006), respectively. In conclusion, serum ECP, but not eosinophils per se, can differentiate normal subjects from naive asthmatics hyperresponsive to UNDW. Serum ECP was also proven to be directly related to both the UNDW-induced bronchoconstriction and hypoxemia, thus confirming that proximal, but also the more peripheral airways, are actively involved. Bronchial hyperresponsiveness to UNDW can then be considered an effective reflection of the existence of underlying inflammation of the airways.

Administration, Inhalation↗