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Biomedical subjects

S Bianco

Publications and source records attributed to S Bianco.

At least 73 records · Page 4Linked to original sources
PubMed1991

Bronchodilating activity of broxaterol transdermal patch and its protective effect on bronchial constriction induced by inhaled distilled water mist.

The bronchodilating activity and the ability of broxaterol transdermal patch to inhibit bronchial constriction in response to distilled water mist (UNH2O) inhalation were assessed. The study was performed in 10 asthmatic patients in clinical remission according to a placebo-controlled, double-blind, randomized crossover design. Test medications were broxaterol patch (size = 1.75 cm2; programmed delivery = 105 mcg/h) and a matched placebo patch. A spirometric examination was performed before patch application (at 8:30-9:00 a.m.) and 24 hours later. Immediately afterwards, the UNH2O inhalation test was made, consisting of 3 bronchial exposures lasting 30, 60 and 120 s respectively with 3-minute intervals between challenges. Immediately after each exposure, a spirometric examination and specific airway resistance measurements were made. The results obtained show that broxaterol patch exerts a statistically significant bronchodilating effect and has a better protective effect than placebo patch on UNH2O-induced bronchial constriction. The local tolerability of patches was very good. Slight tremors were observed in some subjects.

Administration, Cutaneous↗
PubMed1991

[Ultra-pressurized hydrodynamics in surgery].

Like the CO2-laser, a H2O-jet stream may produce a selective cutting effect by working at distance. Because of the innovative possibility to add any kind of pharmacological agents to the ejected operating liquid, the new surgical equipment: Aquatom NTS-1000 allows a deep penetration of efficient medicaments directly into pathological areas, such as met in septic cutaneous diseases.

Animals↗
PubMed1990

Prevention of antigen-induced early obstructive reaction by inhaled furosemide in (atopic) subjects with asthma and (actively sensitized) guinea pigs.

The present study was undertaken to determine the effect of furosemide on antigen-induced bronchoconstriction. Ten patients with stable asthma (eight men and two women), aged 17 to 48 years, were challenged with the same dose of allergen (Dermatophagoides pteronissinus, Parietaria, and grass mix) that had induced an FEV1 fall of at least 20% in a preliminary study on two occasions: immediately after placebo and furosemide (approximately 28 mg) administered by inhalation in random order and double-blind. Furosemide did not demonstrate any direct bronchodilator effect but markedly attenuated allergen-induced bronchoconstriction. The mean (95% confidence interval) maximum fall in FEV1 was 31.5% (40.2% to 22.8%) after placebo and 8.4% (11.8% to 4.9%) after furosemide administration. Furosemide, administered by aerosol to anesthetized guinea pigs actively sensitized to ovalbumin, dose dependently protected the animals from anaphylactic reaction. Infusion of furosemide (10 mg/kg for 10 minutes) failed to protect the animals from the anaphylactic response. In nonsensitized guinea pigs, the cardiovascular and pulmonary changes induced by histamine (10 micrograms/kg intravenously [i.v.]), leukotriene C4 (1 micrograms/kg i.v.), and platelet-activating factor (0.1 microgram/kg i.v.) were not modified by aerosol administration of furosemide (10 mg/ml for 10 minutes). In conclusion, inhaled furosemide induces a clear-cut protection against immediate obstructive reaction caused by areoallergerns and ovalbumin, both in subjects with asthma and actively sensitized guinea pigs, respectively.

Administration, Inhalation↗
PubMed1990

Effect of inhaled frusemide on the early response to antigen and subsequent change in airway reactivity in atopic patients.

The purpose of this study was to investigate whether inhaled frusemide was able to inhibit the increase in nonspecific bronchial reactivity that occurs after the early response to allergen exposure in subjects with allergic rhinitis or asthma (or both). Ten symptom free patients initially underwent a challenge with methacholine, to determine the dose of methacholine that caused a 15% fall in FEV1 (PD15 FEV1 meth) and a challenge with a specific allergen, to determine the concentration of allergen that caused a fall in FEV1 of at least 15%. On two further occasions they inhaled allergen concentration that had caused the greater than or equal to 15% fall in FEV1 preceded by inhaled frusemide (40 mg frusemide in 4 ml buffered saline) or placebo (4 ml of diluent solution), according to a randomised, double blind, crossover design. All allergen studies were separated by at least seven days. A methacholine challenge was performed two hours after the allergen challenge, a time when the early response to allergen had completely resolved. Frusemide inhibited the early response to antigen, causing mean (95% confidence interval) protection of 87.6% (96-80%) for the maximum fall in FEV1. The increase in non-specific airway reactivity that occurred after antigen when this was preceded by placebo was reduced by frusemide. The mean (95% CI) difference in PD15 values between the placebo and the frusemide days was 1.73 (2.30-1.16) doubling doses of methacholine. These results confirm that frusemide is highly effective in preventing the early response to allergen, and show that it inhibits the increase in reactivity to methacholine that follows the early response.

Administration, Inhalation↗
PubMed1990

[Hemorheologic changes in patients with obliterative arteriopathy of the leg before and after muscle exercise tests].

Blood and plasma viscosity, erythrocyte filtrability and blood gas analysis were determined in 25 subjects with arteriosclerosis obliterans of the lower limbs before and after a muscle exercise test. Thirty-six shear rates between 0 and 230 s1 were studied to obtain viscosity curves, and regression analysis was performed for each curve. Mean viscosity curves for pathologic and control populations were plotted. The purpose of the study was to determine whether viscosity curves for blood and plasma before and after exercise, based on a high number of measurements, can provide information on rheological changes during intermittent claudication. Practically all viscosity curves in pathologic and control subjects could be described using a hyperbolic equation. Plasma as well as blood viscosity increased in pathologic subjects after exercise. However, erythrocyte filtrability and blood gas analysis in pathologic and control subjects, and blood and plasma viscosity in control subjects, showed no statistically significant changes after exercise. It is suggested that muscle exercise in reduced blood flow conditions can alter the aggregation of macromolecular complexes of plasma proteins, which could have an influence on cell components by modifying blood rheological behavior during claudication.

Arteriosclerosis↗
PubMed1989

Protective effect of inhaled furosemide on allergen-induced early and late asthmatic reactions.

The movement of ions and water across the membranes of bronchial cells is part of the control of the bronchial obstructive response to physical stimuli. In a double-blind, randomized, crossover study, we compared the effect of an aerosol of the loop diuretic furosemide with that of a placebo on the early (within 60 minutes) and late (4 to 12 hours) asthmatic responses to a specific inhaled allergen. We studied 11 subjects with mild allergic asthma, who had both early and late asthmatic responses to a specific inhaled allergen in a preliminary challenge. After placebo administration, the maximal changes (mean +/- SE) from base line in the forced expiratory volume in one second (FEV1) and specific airway resistance were, respectively, a decrease of 35 +/- 4 percent and an increase of 288 +/- 56 percent between 0 and 60 minutes after inhalation of the allergen (early response) and a decrease of 35 +/- 5 percent and an increase of 301 +/- 40 percent between 4 and 12 hours (late response). After furosemide administration (4 ml; 10 mg per milliliter), the early response to inhaled allergen was markedly attenuated in all the subjects, and the late response in all but one. The maximal changes in the FEV1 and specific airway resistance were, respectively, a decrease of 11 +/- 2 percent and an increase of 61 +/- 2 percent between 0 and 60 minutes and a decrease of 20 +/- 4 percent and an increase of 178 +/- 25 percent between 4 and 12 hours (P less than 0.05 for all comparisons). No significant differences were seen in the bronchoconstrictor response to inhaled methacholine after furosemide or placebo administration. We conclude that a furosemide-sensitive mechanism in the airways is involved in the pathogenesis of the reactions of patients with allergic asthma. Whether inhaled furosemide might be useful in the treatment of allergic asthma is uncertain and will require further study.

Adolescent↗
PubMed1989

Inhaled frusemide is highly effective in preventing ultrasonically nebulised water bronchoconstriction.

A decrease in the osmolarity of the periciliary fluid of central airways is supposed to be the initiating mechanism by which ultrasonically nebulised distilled water (UNH2O) induces bronchoconstriction in asthmatics. It is therefore possible that substances, such as frusemide (F), which, in vitro, interfere with ions and water translocation across the tracheo-bronchial epithelium, can also modify such response. To test this hypothesis, 16 adult asthmatics were challenged with UNH2O after being pretreated with either inhaled F (approximately 28 mg delivered into the mouth) or placebo (the diluent) administered in random order and double-blind by means of a jet nebuliser. F did not modify baseline FEV1 and sRaw but attenuated markedly their changes after UNH2O. Mean max % (95% CI) sRaw increases after placebo and F were 293% (168-419) and 63% (21-104), respectively; mean max % falls in FEV1 were 26% (20-32) and 6% (-1-12). Thus inhaled F is highly effective in preventing UNH2O-induced bronchoconstriction and this unexpected property could have therapeutic implications.

Administration, Inhalation↗
PubMed1989

Role of broxaterol in bronchial hyperresponsiveness.

The protective effect of broxaterol against bronchial hyperresponsiveness has been assessed in several double-blind randomized controlled studies in stable asthmatic patients. In three cross-over studies, broxaterol (400 micrograms by metered dose inhaler) has been shown to significantly reduce methacholine responsiveness 30, 60 and 120 min after dosing. The protective effect was similar to that obtained with terbutaline (500 micrograms), but there was a trend toward a higher activity of fenoterol (400 micrograms), even if counterbalanced by a more frequent occurrence of side effects. Broxaterol 0.5 mg by oral route provided a significant greater protection against the exercise-induced bronchospasm than 0.02 mg of clenbuterol and a placebo. Also in children, broxaterol 0.25 mg as nebulizer solution significantly prevented exercise-induced bronchospasm versus placebo, and this effect was seen to be associated with an improvement in maximal working capacity. Prevention of bronchospasm following 3 or 4 consecutive challenges with inhaled distilled water mist was demonstrated after oral and aerosol administration of broxaterol. This effect was not significantly different from that observed with salbutamol, if administered by aerosol. Finally, in a cross-over placebo-controlled study, broxaterol (400 micrograms by aerosol) significantly inhibited allergen-induced immediate bronchoconstriction. These data suggest that broxaterol represents a new valid alternative to the most effective beta 2-stimulants now commonly used.

Adrenergic beta-Agonists↗
PubMed1989

Effectiveness of nedocromil sodium versus placebo as additions to routine asthma maintenance therapy: a multicentre, double-blind, group comparative trial.

A total of 117 subjects took part in a double-blind, placebo-controlled trial of nedocromil sodium (4 x 4 mg daily by inhalation) in the management of patients with moderately severe bronchial asthma. Treatment was randomly allocated and was continued for 12 weeks following a 2-week baseline period on routine asthma therapy. Statistically significant differences for nedocromil sodium versus placebo were found for diary card asthma severity scores, morning and evening peak flow measurements and daily bronchodilator usage. The clinicians' assessments of asthma severity and global opinions of treatment efficacy were also significantly in favour of nedocromil sodium. Overall, the clinical status of these asthmatic patients was improved by adding nedocromil sodium onto their existing therapy.

Adolescent↗
PubMed1988

Prevention of exercise-induced bronchoconstriction by inhaled frusemide.

To determine whether inhaled frusemide, a diuretic able to interfere with ion and water movement across airway epithelium, can modify exercise-induced bronchoconstriction, a three-part randomised, double-blind, placebo-controlled study was done in asthmatic patients who had a fall in FEV1 of at least 20% after running up and down a corridor. In the first part the effect of approximately 28 mg frusemide given as an aerosol was compared with that of a placebo. In the second part two doses of inhaled frusemide (approximately 14 mg and 28 mg) were examined. In the third part the effect of 20 mg oral frusemide was tested. Inhaled frusemide had a good and dose-related protective effect, whereas oral frusemide was ineffective. The mean (95% CI) maximum percentage falls in the FEV1 were: 11.5 (14.3-8.7) with frusemide and 33.8 (39.1-28.5) with placebo in the first part of the study; 13.6 (21.6-6.0) with 28 mg frusemide, 19.7 (28.2-11.3) with 14 mg frusemide, and 34.6 (39.4-30.0) with placebo in the second part of the study; and 15.2 (19.9-10.5) with inhaled frusemide, 38.2 (47.1-29.3) with oral frusemide, and 35.3 (45.9-24.7) with placebo in the last part of the study. The findings lend support to the hyperosmolarity hypothesis of exercise-induced asthma and may have therapeutic implications.

Administration, Inhalation↗
PubMed1988

Intolerance to tartrazine in aspirin-induced asthma: results of a multicenter study.

One hundred and fifty-six German, Italian and Polish patients with confirmed aspirin-induced asthma underwent open oral challenges with increasing doses of tartrazine up to 25 mg. All positive challenges were repeated under double-blind conditions. Only 4 of 156 patients (all Polish) had positive reactions in a double-blind test, as evidenced by a fall in FEV1 greater than 25% from baseline and corresponding clinical symptoms. Sixty-five patients who tolerated 25 mg tartrazine well received 50-3,000 mg tartrazine and none showed adverse reactions. Thus, intolerance to tartrazine appears to be rare among Central-European and South-European patients with aspirin-induced asthma, its frequency amounting to about 2.6%.

Administration, Oral↗
PubMed1988

Mast cells in bronchoalveolar lavage in sarcoidosis: correlation with alveolar lymphocytes.

Today it is believed that mast cells (MC) are important not only in IgE-mediated reactions, but also in delayed hypersensitivity reactions, and that their functions are mediated by factors released by T lymphocytes. Recent studies have shown their presence in bronchoalveolar lavage (BAL) of patients with asthma and interstitial lung disease. MC have been identified by us in the BAL of patients with sarcoidosis and lung cancer, and in controls. A statistically significant correlation has been found between MC and lymphocytes, CD3+ and CD4+ cells present in BAL, thus supporting the hypothesis of interactions between T lymphocytes and MC in immune reactions at the alveolar level.

Adult↗
PubMed1988

[Pseudotumorous "skip area" in subtotal hepatic steatosis. Echographic and computed tomographic aspects].

In 75 patients ultrasound (US) demonstrated fatty infiltration of the liver with diffuse increased echogenicity except for a solitary hypoechogenic area located in the quadrate lobe. The liver was also followed-up with US, computed tomography (CT), radionuclide scintigraphy, and fine needle biopsy: a skip area unaffected by steatosis was thus demonstrated. This study and further information found in literature allowed the authors to identify the particular US features which lead to a correct interpretation of these findings, which might otherwise be incorrectly diagnosed as suggestive of substitutive lesions (primary or secondary). These features are: 1) the location of skip areas, usually in the IV segment, in close relationship to a portal vessel; 2) their morphology, triangular, or inverted-V shaped; 3) the absence of mass effects upon the hepatic border and/or upon the adjacent vessels; 4) the presence of fatty liver infiltration; 5) the coexistence of a biohumoral pattern significant for diffuse hepatopathy; 6) the lack of change in US patterns during the follow-up.

Biopsy↗
PubMed1988

[Ultrasonics in the diagnosis of hyperplastic cholecystoses of focal and segmental extension type].

The authors describe the sonographic (US) patterns of hyperplastic cholecystoses observed from January 1983 to April 1987 - 39 cases of focal extension and 12 of segmental extension--and confirm the higher sensibility of US versus oral cholecystography. Sonography (SG) allows a straight visualization of the gallbladder wall and its lesions, both in case of limited thickening of the wall (focal cholecystosis) and in case of more extensive thickening (segmental cholecystosis). To cholecystographic findings of focal lesions, SG gives additional information, adding a fundamental diagnostic element: the lack of acoustic shadowing distal to the nodular masses. Nonetheless, SG does not allow a discrimination between focal cholesterolosis and adenomyomatosis, except for particular cases, such as multiple nodular masses, and coexistence with the "comet tail" pattern--the latter due to parietal deposits of cholesterol. Furthermore, the differential diagnosis of focal cholecystoses includes some neoplasms of the gallbladder, and gallstones stuck to the wall, with no acoustic shadowing. In segmental cholecystoses, the direct evaluation of the entity and extension of the wall thickening remains a fundamental diagnostic element, even though such a morphologic detail is often integrated by the functional relieve of hypercontractility of the gallbladder wall after a fatty meal (both oral cholecystography and SG demonstrate it).

Diagnosis, Differential↗
PubMed1987

Prevention of fog-induced bronchospasm by nedocromil sodium.

A single dose double-blind crossover study was performed to compare the efficacy of nedocromil sodium (4 mg) and placebo administered from pressurized aerosols against bronchoconstriction induced by the inhalation of ultrasonically nebulized distilled water (fog) in twelve asthmatic subjects. Neither active nor placebo pre-treatment produced any significant change in baseline FEV1 and SRaw. Nedocromil sodium significantly attenuated fog-induced falls in FEV1 (P less than 0.001) and increased specific airways resistance (SRaw, P less than 0.01). The results provide further evidence of the potential therapeutic usefulness of nedocromil sodium in the management of chronic obstructive airways disease.

Adolescent↗
PubMed1987

Evaluation of a new bronchodilating compound (broxaterol) administered as a pressurized aerosol.

The bronchodilating activity and the tolerability of a new beta 2-agonist, broxaterol hydrochloride, administered in single doses of 200 and 400 micrograms as pressurized aerosol were studied in 12 adult patients with reversible airway obstruction, taking placebo as a control. A double-blind three-way cross-over design using a series of randomly chosen latin squares was employed. FVC, FEV1, MMEF, heart rate, and blood pressure were measured immediately before and 7.5, 15, 30, 60, 120, 180, and 240 min after each treatment. Our results show that broxaterol is an effective bronchodilating drug with a dose-related activity. The areas under the curves of the changes in FVC, FEV1, and MMEF after the 400 micrograms dose were found to be significantly greater as compared to the 200 micrograms dose. Both broxaterol doses produced significant increases in all the spirometric indices already at the first measurement, i.e., 7.5 min after treatment. Broxaterol 400 micrograms induced significant increases in FVC, FEV1, and MMEF through at least 4 h. The tolerability of the new compound was good.

Administration, Inhalation↗
PubMed1986

Perspectives in the treatment of reversible airway obstruction.

The pharmacological therapy of asthmatic syndromes is based essentially on the programmed use of disodium cromoglycate, beta-2-stimulants, antimuscarinics, theophyllines and corticosteroids. However, the continual progress being made in pathogenesis and pharmacology suggests, to an ever-increasing extent, the application of new therapeutic approaches for these diseases, some of which are fairly interesting from a speculative point of view although they are as yet of limited practical value. Calcium antagonists and alpha-blockers have a mild anti-reactive effect but this is not sufficiently potent to justify use of these products in the treatment of asthma unless there are also cardiovascular disorders for which these drugs are particularly indicated. Despite the initial promising prospects, all attempts to obtain PGE analogues of therapeutic value as antiasthmatics have proved fruitless. Research into orally active chromone derivatives has proved equally unproductive. On the other hand, certain new inhalatory chromones are decidedly more promising. Specific antagonization of mediators (histamine, prostaglandin, leukotrienes) did not produce the effect hoped for in asthma, but this was foreseeable insofar as the major pathogenic mediators are too vast in number (and no doubt there are still many more to be discovered) to allow one to conceive it possible to achieve a satisfactory therapeutic effect by merely blocking some of them. Inflammation of the bronchial wall is currently considered to be one of the basic pathogenic factors provoking the recurrence of asthma: this is proved indirectly by the potent antiasthmatic effect of corticosteroids which are the most effective anti-inflammatory agents. As regards nonsteroidal anti-inflammatory drugs (NSAID), however, matters are more complicated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗