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Biomedical subjects

F Bariffi

Publications and source records attributed to F Bariffi.

At least 19 recordsLinked to original sources

Effect of inhaled heparin on water-induced bronchoconstriction in allergic asthmatics.

OBJECTIVE: The aim of this study was to investigate the effect of inhaled heparin on bronchoconstriction induced by ultrasonically nebulised distilled water (UNDW) in allergic asthmatics. METHODS: Eight atopic asthmatics, hyperresponsive to UNDW, were selected for this randomised, placebo-controlled, crossover double-blind study. On two consecutive days, these subjects underwent a UNDW challenge 45 min after inhaling aerosolised heparin (1000 U/kg) or placebo. RESULTS: Neither heparin nor placebo had a significant effect on base-line forced expiratory volume in 1 s (FEV1), but heparin significantly attenuated UNDW-induced bronchoconstriction, as shown by its efficacy in preventing the decreases in FEV1 produced by all doses of water (in comparison with placebo: P < 0.05 after 2 ml water; P < 0.01 after 4, 8 and 16 ml water). CONCLUSION: Inhaled heparin is able to exert a protective effect against the bronchoconstrictive response to UNDW in allergic asthmatics, and this action is likely due to inhibition of mast cell degranulation.

Administration, Inhalation↗

Effects of non-bronchoconstrictive doses of inhaled propranolol on airway responsiveness to methacholine.

OBJECTIVES: The aim of this study was to evaluate the effects of non-bronchoconstrictive doses of propranolol on airway hyperresponsiveness to methacholine. METHODS: Double increasing concentrations (from 0.03 to 64 micrograms/ml) of inhaled propranolol were administered to a study population which included ten patients with mild asthma, ten rhinitics, and ten healthy control subjects. After the baseline bronchial responses to propranolol and methacholine, expressed as the cumulative provocative dose producing a 20% fall in forced expiratory volume in 1 s (PD20FEV1), were assessed, methacholine challenge was repeated after pretreatment with non-bronchoconstrictive doses of propranolol. RESULTS: The pharmacologically induced beta-blockade did not cause any effect in normal individuals, but it worsened airway responsiveness to methacholine in all asthmatics (geometric mean PD20 FEV1: 257 and 87 micrograms, respectively) and some rhinitics (geometric mean PD20 FEV1: 724 and 446 micrograms, respectively). CONCLUSION: Asthmatic patients were extremely sensitive to beta-blockers, whereas we observed a variable response to propranolol within the group of rhinitic subjects. This variability in the latter group is possibly because these individuals had different degrees of airway inflammation, increased parasympathetic activity, and beta-adrenoceptor dysfunction.

Administration, Inhalation↗

First report of the Italian register for diffuse infiltrative lung disorders (RIPID).

RIPID was established in 1998 as a joint project of the major Italian scientific societies for Respiratory Medicine, with the aim to create an Italian Register on diffuse infiltrative lung disorders that can provide the basis for epidemiological and clinical studies of adequate sample size. In the period from May 1998 to December 2000, 1,382 cases were submitted from 54 Centers in 15 regions of Italy, 54.2% males (mean age +/- SD 50.5 +/- 16.8 years) and 45.8% females (50.2 +/- 15.3 years). A current smoking habit emerges in 18% of subjects; former smokers and never-smokers represent 26% and 56% of the total case series, respectively. The most frequent disease registered is idiopathic pulmonary fibrosis (37.6%), followed in decreasing order by sarcoidosis (29.2%), and Langherans' cell hystiocytosis (6.6%). High resolution computed tomography (HRCT) was considered as the most important tool for final diagnosis in the majority of cases (74.4%); 39.4% of patients underwent transbronchial biopsies, 39.2% bronchoalveolar lavage (BAL). A surgical biopsy was performed in 20.5% of patients. A web site has been activated from December 2000 (www.pneumonet.it/ripid), allowing prompt access to all information and scientific material concerning the project and to an electronic form for data collection that can be completed on-line.

Adult↗

Mycobacterium tuberculosis and HIV co-infection in the lung: synergic immune dysregulation leading to disease progression.

There is evidence that Mycobacterium tuberculosis (Mtb) impacts on human immunodeficiency virus (HIV) infection and that HIV promotes mycobacterial diseases. Epidemiological and clinical studies demonstrate the detrimental effect of tuberculosis (TB) on the progression of HIV infection, that is an increased risk of death among Mtb-HIV co-infected patients. Pulmonary TB may occur very early during HIV infection, whereas extrapulmonary or atypical manifestations are associated with more profound immunodeficiency, showing features like mycobacteraemia and multi-drug resistance, much more severe than in immunocompetent hosts. During the last decade, many efforts have been focused on the immunological aspects of Mtb-HIV co-infection. The host protective response to TB is mediated by cell immunity, which, mainly supported by interleukin (IL)-12 and interferon (IFN)-gamma production, leads to granuloma formation. Perturbations in the cytokine expression, that is a reduced type-1-like response, have been suggested in HIV-infected patients to contribute to their susceptibility to TB. Indeed, an impaired balance between pro-inflammatory and anti-inflammatory cytokines and apoptosis-induced depletion of immune effector cells account for the dissemination of both the pathogens and for a poor granulomatous reaction in Mtb-HIV co-infected patients. However, the recently elucidated role of chemokines and their receptors in immune regulation opens new questions on the pathogenesis of Mtb-HIV co-infection.

Cytokines↗

Lung cancer metastatic cells detected in blood by reverse transcriptase-polymerase chain reaction and dot-blot analysis.

PURPOSE: We analyzed the blood of patients with lung cancer at different stages of presentation for the presence of carcinoembryonic antigen (CEA) mRNA detected by reverse transcriptase-polymerase chain reaction (RT-PCR) combined with the dot-blot procedure as an indicator of micrometastatic malignant cells. PATIENTS AND METHODS: We studied 24 lung cancer patients (10 with distant metastases and 14 with no evidence of distant metastases), eight age- and sex-matched patients affected by nonneoplastic respiratory diseases (four smokers), and eight healthy subjects. We used immunohistochemistry and RT-PCR dot-blot analysis to evaluate CEA expression in the neoplastic tissue, and the RT-PCR dot-blot procedure to analyze CEA mRNA in circulating cells. RESULTS: The RT-PCR dot-blot procedure was highly sensitive aspecific: it detected CEA mRNA in samples of RNA from lung cancer diluted 10(6)-fold with RNA extracted from normal blood cells, and sequence analysis confirmed that the amplified product was CEA. CEA mRNA was found in circulating cells from eight of 10 lung cancer patients with distant metastases (diagnostic sensitivity, 80%) and in four of 14 patients with no evidence of distant metastases. Two of the latter had distant metastases within 6 months of analysis. Thus, the diagnostic specificity of the analysis toward lung cancer without distant metastases was 86%. The analysis was negative in the eight nonneoplastic patients and in the eight healthy controls. CONCLUSION: The RT-PCR dot-blot analysis of CEA mRNA in blood cells seems to be a promising tool for the early detection of micrometastatic circulating cells in patients with lung cancer.

Aged↗

Inhaled beclomethasone dipropionate (BDP) prevents seasonal changes in atopic asthmatics.

Inhaled corticosteroids are most effective drugs currently available for the treatment of bronchial asthma. They have been shown to reduce airway inflammation and hyperresponsiveness. The aim of this study was to assess the preventive effect of inhaled steroid therapy in seasonal asthma. In a double-blind study, two groups of 10 allergic asthmatics were randomly assigned to receive inhaled beclomethasone dipropionate (BDP), 500 micrograms b.i.d., or a matched placebo, two puffs b.i.d. The patients used inhaled salbutamol as needed. At the beginning of the study, and every month between February and June, the following parameters were assessed: lung function (forced expiratory volume in one second (FEV1); airway responsiveness (provocative dose of methacholine producing a 20% fall in forced expiratory volume in one second (PD20)), serum eosinophil cationic protein (ECP); and blood eosinophil count. All subjects recorded daily asthma symptoms, beta 2-agonist consumption and peak expiratory flow (PEF) values. In the placebo group, all parameters except FEV1 worsened significantly during the pollen season compared with preseasonal values (p < 0.001). BDP produced complete protection, although a slight change from baseline was found for symptom score (p < 0.01), beta 2-agonist consumption (p < 0.01), and eosinophil number (p < 0.05) in May, when the pollen load was highest. These data provide evidence that beclomethasone dipropionate treatment is able to inhibit the seasonal changes occurring during natural exposure in asthmatics. This preventive effect is probably due to the anti-inflammatory action of beclamethasone dipropionate, as documented by its effect on serum markers of airway inflammation.

Administration, Inhalation↗

Serum eosinophil cationic protein (ECP) as a marker of disease activity and treatment efficacy in seasonal asthma.

This study was carried out to determine whether serum eosinophil cationic protein (ECP) represents a sensitive marker for disease activity in atopic asthmatic patients during the pollen season. The study, in double-blind fashion, was performed between February and June 1994. Two groups of 10 seasonal asthmatic patients randomly received two different treatments. The first group was treated with inhaled beclomethasone dipropionate (BDP) 500 micrograms bid; the second received a matched placebo (P). At the beginning and every month, blood samples for determination of ECP and eosinophil count were collected and lung function (FEV1) and methacholine responsiveness (PD20) were performed. Subjects recorded daily symptoms of asthma, salbutamol consumption, and peak expiratory flow (PEF) values. In the P group, all indices, except FEV1, showed significant changes during the pollen season (P < 0.001). In the BDP group, significant changes were detected for symptom score (P < 0.01), salbutamol consumption (P < 0.01), and eosinophil number (P < 0.05). Between the two groups, significant differences for symptom score (P < 0.001), salbutamol consumption (P < 0.001), ECP levels (P < 0.05), eosinophil count (P < 0.02), PD20 methacholine (P < 0.02), and PEF values (P < 0.01) were detected. Changes in serum ECP significantly correlated with changes in other parameters (P < 0.001), except FEV1. Our results provide evidence that serum ECP is a sensitive marker for monitoring of the disease activity in seasonal asthma. Furthermore, it may offer a useful tool for estimating treatment efficacy.

Adult↗

Epidemiology of lower respiratory tract infections.

The aim of this review is to focus on the epidemiology of lower respiratory tract infections, the etiology, prognosis and risk factors, dividing these problems into the following issues: global impact of these afflictions, community-acquired pneumonia, hospital acquired pneumonia, respiratory infections in surgery, acute bronchitis and exacerbations of chronic bronchitis. Every year about 5 million people die of acute respiratory infections. Among these, pneumonia represents the most frequent cause of mortality, hospitalization and medical consultation. Several factors (age, underlying disease, environment) influence mortality, morbidity and also microbial etiology. The authors also refer to recent data on the most frequently identified antibiotic resistance of respiratory pathogens. The knowledge of such different clinico-epidemiological situations is essential to physicians for an effective approach to treatment of pneumonia and bronchitis.

Adolescent↗

Effect of ipratropium bromide and/or sodium cromoglycate pretreatment on water-induced bronchoconstriction in asthma.

The mechanisms underlying water-induced bronchoconstriction are still not fully understood. Cholinergic reflexes and mast cell mediator release are currently believed to play an important pathogenetic role. In order to evaluate the relative contribution of each of these mechanisms, we studied the effect of ipratropium bromide (80 micrograms), a muscarinic antagonist, and sodium cromoglycate (20 mg), an inhibitor of mast cell mediator release, administered alone and in combination, in the prevention of bronchospasm induced by ultrasonic mist of distilled water (UMDW). Fifteen patients with documented atopic asthma and hyperresponsiveness to distilled water were selected for this randomized, placebo-controlled, double-blind study. Airway responses to pharmachological agents and bronchial challenge were measured by change in specific airways conductance (sGaw). Sodium cromoglycate had no effect on bronchial calibre, whilst ipratropium bromide and the combination of the two drugs produced a significant bronchodilation 30, 60 and 90 min after treatments. The maximal increase in sGaw (mean % +/- SD) was observed at 90 min: 63 +/- 28% and 58 +/- 22% after ipratropium bromide and the combined drugs respectively. UMDW (2, 4, 8, 16 ml water) caused a -36 +/- 19%, -42 +/- 19%, -49 +/- 18%, -56 +/- 15% mean % +/- SD fall in sGaw after placebo. Pretreatment with sodium cromoglycate abolished the bronchoconstriction to 2 ml (fall sGaw -5 +/- 23% NS) and significantly reduced the effect of 4 (-15 +/- 22%), 8 (-21 +/- 20%) and 16 ml (-24 +/- 18%) water.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗

Evaluation of the efficacy of pidotimod in the exacerbations in patients affected with chronic bronchitis.

The efficacy and safety of pidotimod ((R)-3-[(S)-(5-oxo-2-pyrrolidinyl)carbonyl]-thiazolidine-4-carboxylic acid, PGT/1A, CAS 121808-62-6), a new oral synthetic immunostimulating agent, were investigated in a multicentre study, performed in 10 university and hospital centres of pneumophthisiology and respiratory physiopathology, according to a double-blind vs. placebo experimental design. Primary objective of the investigation was to verify the efficacy of pidotimod against infectious exacerbations in patients affected with chronic bronchitis. 181 inpatients or outpatients (117 male, 64 female; mean age: 62.5 years), affected with chronic bronchitis, were enrolled in the study. Pidotimod 800 mg/die or placebo sachets were administered by oral route for 60 consecutive days, followed by a 60-day follow-up period. Clinical observations were performed at baseline (D 0), after 30 (D 30) and 60 (D 60) days of treatment, as well as at the end of the follow-up (D 120). Time and frequency of infectious relapses were considered as the target variable for the evaluation of the efficacy of the drug. Clinical picture, expectoration characteristics, spirometric parameters and laboratory tests were monitored to evaluate patients' conditions. The results indicate that pidotimod is significantly more effective than placebo against infectious relapses in patients suffering from chronic bronchitis. During the first month, 9% of patients treated with pidotimod were affected with an infectious relapse vs. 39.5% of patients treated with placebo (chi 2, p < 0.001). In the second month, infectious episodes were reported by 1.2% of patients treated with the drug vs. 46.1% of patients treated with placebo (chi 2, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Protective effect of levodropropizine against cough induced by inhalation of nebulized distilled water in patients with obstructive lung disease.

Levodropropizine is a recently developed, peripherally active antitussive agent which is widely used in clinical practice. In order to obtain further information on the spectrum of activity of this compound in experimental clinical models, a double-blind controlled study was carried out to evaluate the potential effect of the drug against cough and bronchoconstriction induced by inhalation of an ultrasonically nebulized solution of distilled water in patients with obstructive lung disease. Twenty patients were randomly divided into two groups, which received levodropropizine (60 mg t.i.d.) or placebo respectively for 7 consecutive days. Parameters evaluated at baseline and on the last day of treatment included (i) results of respiratory function tests (FEV1, IVC, FVC, TIFF, PEF, MEF75, MEF50, MEF25) performed before the stimulation test with nebulized water; (ii) total number of coughs during a 2-hour period after the stimulation test; (iii) bronchial responsiveness, quantified by calculating the volume of nebulized water required to induce a 20% reduction of FEV1 below the basal level. At pretreatment, the tussive response was very similar in the two groups. A significant decrease in number of coughs (from 34.4 +/- 8.4 at baseline to 15.6 +/- 4.9 post-treatment, p less than 0.01) was observed after administration of levodropropizine, whereas placebo treatment produced no significant effect (number of coughs: 29.6 +/- 4.9 at baseline vs 24.8 +/- 9.6 post-treatment, N.S.). Bronchial responsiveness decreased significantly (compared to baseline) in both treatment groups, without any significant difference between drug and placebo. Respiratory function tests were not significantly affected by either treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Serodiagnosis survey of tuberculosis by a new ELISA method.

In a survey study, the authors used a new Elisa test, designed by Anda Biologicals, Strasbourg, France, to detect specific IgG and IgM antibodies against A60 antigen. Blood samples from 53 subjects were tested with this serological method: 22 with no tubercular diseases and 31 affected by different tubercular lesions. The IgM titers were negative in all control group subjects, in two out of fourteen patients with progressive primary tuberculosis, in thirteen out of sixteen with secondary tuberculosis and in one patient with extrapulmonary tuberculosis. The IgG titers were positive (greater than 1.25 Elisa units) in all cases, except one, of progressive primary tuberculosis, in all cases, except two, of secondary tuberculosis and in the patient affected by extrapulmonary tuberculosis. The performance of this method and the overall results indicate its sensitivity and reliability to detect specific mycobacterial antibodies at different stages of the disease.

Adolescent↗

A comparative study of ofloxacin versus cefazolin in lower respiratory tract infections.

An open study was conducted in 40 randomized patients to evaluate the efficacy of ofloxacin in comparison with cefazolin in the treatment of acute, chronic and recurrent lower respiratory tract infections. The therapeutic efficacy of the two drugs was evaluated on the basis of bacteriological and clinical examinations. Bacteriological assays revealed that ofloxacin eliminated bacterial flora from sputum in 20/21 cases (14 Gram-negative and 7 Gram-positive), while cefazolin eradicated the pathogens in 12/19 cases (16 Gram-negative and 3 Gram-positive). In clinical terms, 20/21 (95.2%) infections were cured and 1/21 (4.8%) improved in the ofloxacin group as against 12/19 (63.2%) cured, 5/19 (26.3%) improved and 2/19 (10.5%) unchanged in the cefazolin group. The results of this study confirm the efficacy and excellent tolerance of ofloxacin in the treatment of lower respiratory tract infections.

Adult↗

Evaluation of the efficacy of the combination of fenoterol and ipratropium bromide (Duovent) in asthmatic subjects.

The efficacy of the combination of fenoterol and ipratropium bromide (Duovent) versus placebo was evaluated in 20 asthmatic subjects. A double-blind crossover design was used during 2-day experimental evaluation: on the 1st day all patients were given a double metered dose of each preparation (Duovent and placebo) by an inhaler, with a 30-min interval; on the 2nd day the sequence of administration was reversed. The functional parameters were evaluated before administrations and at 30, 60 and 90 min after the first administration. The investigation showed that Duovent had a noticeable bronchodilating activity at 30 min, further increasing at 60 and 90 min, without the occurrence of side-effects.

Adult↗

Pulmonary involvement in Sjögren's syndrome.

In this study we tried to value the frequency and the characteristics of the physiological abnormalities affecting the lungs in Sjögren's syndrome (SS). We studied 18 female nonsmokers (average age 53 years). The diagnosis has been made on the presence of at least two of the following abnormalities: keratoconjunctivitis sicca (Schirmer's test), xerostomia (scanning of the salivary glands, lip biopsy) and collagen vascular disease. We made the following tests: clinical examination, chest roentgenogram, spirometry, TGV, RAW and SAW valuation, study of the flow-volume curves, diffusion capacity test, bronchoalveolar lavage, bronchial biopsy. The physiological results have demonstrated the presence of a restrictive syndrome affecting above all the small airways (MEF25-32.7%) and a decrease of the diffusion capacity (DLCO-25%). There is, moreover, a constant lymphocytic infiltration of the bronchial mucosa and of the lung's interstitium. In conclusion the pulmonary involvement in SS seems to be constant, unpredictable and of remarkable clinical-physiological importance.

Adult↗