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Biomedical subjects

F Palermo

Publications and source records attributed to F Palermo.

At least 37 records · Page 2Linked to original sources
PubMed1989

Lung permeability in smokers after ambroxol treatment.

There is evidence suggesting the involvement of the surfactant system in the development of lung diseases in cigarette smokers. The aim of the present study was to evaluate the effect of Ambroxol on lung epithelial permeability (LEP) in healthy smokers. Ambroxol is known to stimulate surfactant production. Twenty male patients aged between 20 and 60 years participated in the study. They all smoked at least 15 cigarettes daily for 10 years. We carried out a random double-blind study versus placebo: the drug (Ambroxol 75 mg) or the placebo were given once a day after breakfast for 30 days. Lung permeability was evaluated through scanning pulmonary scintigraphy by inhalation of the polydispersed liquid aerosol diethylenetriaminepentaacetic acid (DTPA), labelled with 99Tc, and delivered by a 'Venticis' system. LEP was expressed as the half-time clearance from the lung of 99Tc-DTPA (T50). The significance of the differences between the two treatments was determined by the Student's test for unpaired data. LEP was not different from the baseline value (T50 = 18.49 min) after placebo administration (T50 = 19.57 min). The patients receiving Ambroxol showed an increased LEP mean value (T50 = 18.36 min) in comparison with the baseline mean value (T50 = 16.41 min). Our results demonstrate that the treatment with Ambroxol was able to decrease LEP in 6 subjects, though not significantly.

Adult↗
PubMed1989

Diagnostic efficacy of dynamic radiothallium uptake in thyroid nodules determined by computer-assisted scintigraphy. Reevaluation of a radioisotopic procedure.

Radiothallium (201Tl) has been proposed as a tracer in nuclear medicine for the diagnosis of cold thyroid nodules. Its potassium-mimetic characteristics, like those of 131Cs, can provide information on its turnover in the thyroid nodules; this serves as a basis for the distinction between benign and malignant thyroid tumours. The author presents a study on the diagnostic efficacy of 201Tl as a tracer for thyroid nodules with the aim of evaluating the dynamic uptake and the biodistribution of 201Tl after intravenous injection of 555-740 kBq/kg. A quantitative analysis was made by continuous scanning of 201Tl distribution during the first 20-30 min following thallium injection, with further surveys from 40 to 60 min or more when fixation in a nodule was demonstrated. The ratio between 201Tl uptakes in the nodule and in healthy tissue (density index) was calculated and a multiparametric analysis of the corresponding activity/time curves was performed. This study included 176 patients. Concordance between clinico-histological diagnosis and radio-isotopic findings was demonstrated in 102 out of 106 colloidocystic goitres, in 42 out of 48 benign nodules including thyroiditis, and in 21 out of 22 malignant tumours; a significant statistical difference in the density index between solid and cystic nodules, but no difference between benign and malignant nodules; and a different 201Tl dynamic behaviour in nodules of different nature, with a clear statistical difference in the thallium release between malignant nodular and healthy tissue (nodular disappearance index). This method can improve the diagnosis value of scintigraphy for thyroid nodules enhancing the sensitivity of the radioisotopic applications in comparison with other non-invasive techniques.

Adenocarcinoma↗
PubMed1989

Effect of an aerosol delivery system on bronchodilator activity.

Metered dose inhalers (MDIs) are often used incorrectly by patients who find difficulty using MDI for drug inhalation. The study was performed in 11 asthmatic patients in four days in order to evaluate the efficiency of a new Drug Delivery System (DDS-InspirEase) for metered dose inhalers. Clenbuterol was administered via DDS and via conventional MDI in a randomized manner. On the first two days, DDS and MDI were used by patients without any physician's help. On the subsequent days, clenbuterol was administered via DDS and via conventional MDI directly by the physician. FEV1 and MEF75 values were measured 15', 30', one hour, and two hours post-drug inhalation. Statistical analysis (ANOVA) showed that clenbuterol delivered by DDS, administered by patients or by physician, produced a greater increase in FEV1 values (P less than .05) and MEF75 values (P less than .01) in comparison to the conventional MDI on each test day. No significant differences existed between physician or patient administration of clenbuterol with DDS and MDI. The results showed a greater bronchodilator effect obtained by clenbuterol delivered by DDS.

Adult↗
PubMed1988

Effect of vasoactive intestinal peptide (VIP) on propranolol-induced bronchoconstriction.

There is now considerable evidence in favor of vasoactive intestinal peptide (VIP) as a neurotransmitter of nonadrenergic noncholinergic nerves in the airways. The purpose of our study was to evaluate the influence of inhaled VIP on bronchomotor tone after a beta-adrenergic- and cholinergic-receptor blockage. The study was performed in six patients with asthma in 4 days. On the first day, a propranolol provocative dose producing a 20% change in FEV1 (PD20) was determined from the individual semilogarithmic dose-response curve. On the other days, the propranolol challenge was performed after inhalation of ipratropium bromide (40 micrograms), VIP (70 micrograms), and both drugs in randomized double-blind order. Statistical analysis was performed by two-way analysis of variance. The results demonstrated that mean propranolol PD20 was 0.14 mg (geometric mean + SD = 1.22). Ipratropium bromide administration, like VIP administration, significantly raised the PD20 value. The administration of both drugs elicited a further remarkable increase of mean propranolol PD20. The results demonstrated that inhaled VIP influences bronchomotor tone and that this effect is independent of the cholinergic blockage.

Adult↗
PubMed1988

Comparative study of the effects of nedocromil sodium (4 mg) and sodium cromoglycate (10 mg) on adenosine-induced bronchoconstriction in asthmatic subjects.

The effect of nedocromil sodium (4 mg; 7.8 X 10(-6) M) on adenosine-induced bronchoconstriction was compared with that of a higher dose of sodium cromoglycate (10 mg; 24.1 X 10(-6) M). Eleven allergic asthmatic patients (mean age 26.28 +/- 12.21 years) were studied. Adenosine (0.03-4.00 mg) was administered as nebulized aerosol. The dose of adenosine producing a 20% change in FEV1(PD20) was calculated from the individual semi-logarithmic dose-response curves. Patients were studied on 4 separate days. On the first day the adenosine challenge was performed; on subsequent days patients were pretreated (20 min before challenge) with either placebo or test drug (nedocromil sodium 2 x 2 mg or sodium cromoglycate 2 x 5 mg) administered by pressurized aerosol in a randomized, double-blind manner. Statistical analysis was performed by two-way analysis of variance. Neither sodium cromoglycate nor nedocromil sodium showed a significant bronchodilator effect. In patients treated with placebo, inhalation of adenosine produced a dose-related bronchoconstriction with a geometric mean PD20 of 0.42 mg. After drug administration the mean PD20 values were 1.29 mg with sodium cromoglycate and 2.30 mg with nedocromil sodium. Both drugs produced a significant increase in mean PD20 value in comparison with placebo and baseline (P less than 0.01). These results demonstrate that nedocromil sodium (4 mg) is significantly more potent than a larger dose of sodium cromoglycate (10 mg) in inhibiting adenosine-induced bronchoconstriction (P less than 0.05).

Adenosine↗
PubMed1988

Effect of nedocromil on bronchospasm induced by inhalation of substance P in asthmatic subjects.

Several studies have demonstrated that neuropeptides are present in peptidergic fibres of bronchial tissue. The aim of the present study was to evaluate in vivo the effect of nedocromil sodium (2 x 2 mg) on bronchospasm induced by inhalation of substance P. Six moderate asthmatic patients, mean age 25.17 years, were studied. Airway response was measured as FEV1 and the dose of substance P (using a dose range of 23-736 nmol) producing a 20% decrease in FEV1 (PD20) was calculated from the individual semilogarithmic dose-response curves. Patients were studied on 3 separate days in a randomized, double-blind manner. On the first day a baseline PD20 value was determined. On subsequent days substance P challenge was performed after pretreatment (20 min before challenge) with either placebo or nedocromil sodium. Student's paired t-test and Wilcoxon's test were used for statistical analysis. The results of this study demonstrated that inhalation of substance P causes a dose-dependent bronchoconstriction and that the bronchoconstriction induced by substance P can be prevented by pre-treatment with nedocromil sodium.

Adolescent↗
PubMed1988

Enhancing effect of dipyridamole inhalation on adenosine-induced bronchospasm in asthmatic patients.

The study was performed on 13 asthmatic patients to determine whether inhaled dipyridamole would act directly by inducing bronchoconstriction or indirectly by potentiating the adenosine-induced bronchoconstriction. The study was performed in 3 consecutive days. On the first day adenosine challenge was performed and the PD20 value calculated. On the other days the adenosine challenge was done 5 min after randomized inhalations of dipyridamole or a control solution. The mean percent change in FEV1 after dipyridamole (delta % = 2.0) and control solution (delta % = 1.0) was not significant. Inhaled adenosine caused bronchoconstriction with a geometric mean PD20 of 1.09 mg. After control solution inhalation, a mean PD20 value of 1.31 mg was observed. Dipyridamole inhalation increased adenosine hyperresponsiveness and in all subjects shifted the dose-response curves of adenosine challenge to the left with a mean PD20 value of 0.40 mg. This enhancing effect of dipyridamole was significant when compared with the baseline value (P less than 0.01) and control solution (P less than 0.01). The study demonstrated that dipyridamole inhalation increased airway responsiveness to adenosine in all subjects. This effect is due to indirect activity of dipyridamole on airways without changes in baseline airway caliber.

Adenosine↗
PubMed1988

Effect of sodium cromoglycate and nifedipine on adenosine-induced bronchoconstriction.

Inhaled adenosine causes bronchoconstriction in asthmatic patients. In 7 symptom-free asthmatics a study was performed to investigate the effect of sodium cromoglycate and nifedipine on adenosine-induced bronchoconstriction. All patients were challenged with increasing doses (from 0.03 to 2 mg) of nebulized adenosine to assess airway reactivity. The same procedure was repeated on different days at the same time each morning after administration of placebo and drugs in a randomized double-blind study. Airway response was measured as the forced expiratory volume in 1 s (FEV1). The PD20 value and the fall of FEV1 at the provocative dose were calculated. The PD20 data were modified in log values and the statistical analysis was performed by two-way analysis of variance. Mean decrease of FEV1 after adenosine challenge was 26.02 and 28.87% with placebo sodium cromoglycate and placebo nifedipine, respectively. Sodium cromoglycate and nifedipine gave a mean decrease of FEV1 of 6.44% (p less than 0.05) and 22.22%, respectively. PD20 values (geometric mean) after adenosine inhalation were 0.72 and 0.74 mg for placebo sodium cromoglycate and placebo nifedipine and 0.86 mg for nifedipine. Sodium cromoglycate gave a significant protection against adenosine in all subjects and in no case did the maximum dose used (2 mg) result in a fall in FEV1 value greater than 20%. Adenosine antagonism could be considered as a possible factor contributing to the pharmacologic efficacy of sodium cromoglycate in asthmatic patients. No protective effect was noticed with nifedipine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗
PubMed1988

Bronchospasm induced by inhalation of substance P: effect of sodium cromoglycate.

The aim of this study was to evaluate in vivo the effect of inhaled substance P (SP) and to determine the effect of sodium cromoglycate (SCG) on bronchospasm induced by its inhalation in 6 asthmatic patients. At the beginning of the study, all patients were asymptomatic, with an FEV1 value not less than 20%. SP was administered as aerosol, prepared in 0.9% saline to produce a dose range of 0.03-1 mg. Airway response was measured as FEV1 using a pulmonary system 47120A Hewlett-Packard instrument. The dose of SP producing a 20% change in FEV1 was calculated from the individual semi-logarithmic dose-response curve (PD20). After administration of the placebo, SP produced a dose-related bronchoconstriction with a geometric mean PD20 of 0.15 mg. After SCG, the mean PD20 value was of 0.64 mg (p less than 0.01). These results confirmed the bronchospasm induced by inhalation of SP and demonstrated that SCG is able to prevent this effect although it is impossible to define the exact mechanism of the drug.

Administration, Inhalation↗
PubMed1988

Radioisotope evidence of varying transit of solid food in gastrectomized patients with and without dumping syndrome.

Of 29 Billroth II gastrojejunostomy patients studied by scintigraphy, 11 were dumpers and 18 were non-dumpers; of 20 controls, 11 were patients with different gastric complaints and 9 volunteers with no history of gastrointestinal pathology. The tracer used was human albumin microspheres labelled with 99mTc, mixed thoroughly with a fresh scrambled egg, cooked as an omelet and eaten as a sandwich with white toasted bread. The transit and emptying of the radiolabelled meal in the gastric and derivative loop areas were followed with gamma camera 90-120 min. In the dumpers half-emptying times were significantly shorter than in the controls; in the non-dumpers they were even shorter. Dynamic selective analysis of the radiolabelled food transit through derivative afferent and efferent loops showed, on the other hand, different patterns for the two groups of gastroresected patients: the progression of propulsive waves was very irregular and constantly hyperperistaltic only in the dumpers.

Administration, Oral↗
PubMed1988

Evaluation of the activity of the carbocysteine-sobrerol combination on mucus spinnability.

Among the rheological properties of bronchial mucus, "spinnability", i.e. the ability to form threads under the effect of traction, should be regarded as the most closely related to the mucociliary transport function. In the present study the "spinnability" parameter was included in the functional tests aimed at evaluating the efficacy of the carbocysteine-sobrerol combination in 16 patients suffering from chronic abstructive lung disease with bronchial hypersection. Treatment was administered for ten days under double-blind conditions compared with a placebo. The results obtained showed the tested combination to be able to favourably affect all the most important rheological parameters of mucus, including spinnability, leading to a rapid disappearance of signs and symptoms and to the improvement of the most important respiratory function indexes.

Carbocysteine↗
PubMed1987

Relationship of serum theophylline concentrations to histamine-induced bronchospasm.

This study was performed in a randomized double-blind manner on 6 separate days in 10 asthmatic patients to investigate the effect of a sustained theophylline on baseline bronchial hyperreactivity to histamine in relation to the theophylline serum levels and the degree of bronchodilatation produced. No significant bronchodilatation was seen after theophylline administration at every time of evaluation. An improvement of PD20 values of histamine was observed after 4 h (p less than 0.05), 8 h (p less than 0.01) and 12 h (p less than 0.05) from theophylline administration versus respective PD20 values obtained with placebo at the same times. No significant correlation was found between serum theophylline levels and percentage change of PD20 values after drug administration (r = 0.250). We observed an improvement of PD20 mean values in relation to the maximal serum theophylline concentration but our study failed to correlate the degree of protection with serum concentration.

Administration, Inhalation↗
PubMed1987

Influence of asthmatic and rhinitic symptomatology duration on bronchial responsiveness to histamine.

Our Study aimed to investigate the influence of the time in years elapsed from the onset of symptoms on bronchial nonspecific responsiveness in rhinitic and asthmatic patients. The study was performed on 83 asthmatic patients and on 46 patients with allergic rhinopathy. The beginning of the symptoms and years of asthmatic or rhinitic history were particularly investigated. A histamine challenge was performed. The dose of histamine producing at 20% change in FEV1 (forced expiratory volume in one second) was calculated from the individual semilogarithmic dose-response curve (PD20). Bronchial responsiveness to histamine showed wide variability in subjects of two groups, and an overlap of the distribution curves was observed between asthmatic and rhinitic patients. A significant relationship (p less than 0.01) between the years elapsed from the onset of symptoms and bronchial responsiveness to histamine was observed in each group of patients. We noticed that the number of the years passed heightened the bronchial responsiveness to histamine in both groups of patients.

Adolescent↗
PubMed1987

Bronchodilator effect of Aerochamber and Inspirease in comparison with metered dose inhaler.

This trial was performed in a randomized double-blind manner on four different days in 13 asthmatic patients in order to compare the bronchodilator efficacy of two different inhalation devices, Inspirease (IP) and Aerochamber (AC), to the conventional metered dose inhaler (MDI). The results showed that clenbuterol determined a significant FEV1 increase inhaled either via MDI or via IP and AC. IP caused a greater bronchodilatation than AC, 30 min after clenbuterol administration. IP caused a greater mean increase (P less than 0.05) in FEV1 than the MDI at all time intervals; AC provided an improvement in bronchodilator response over directly administered MDI. Such responses are only marginally clinically relevant when patients use MDI correctly. These devices are mainly indicated in patients with poor hand-lung coordination.

Adult↗
PubMed1986

Effect of Duovent (ipratropium bromide and fenoterol) on non-specific bronchial hyperreactivity.

Beta 2-adrenergic and anticholinergic drugs have shown an action in modulating bronchial hyperreactivity to various stimuli (chemical, physical, immunological, pharmacological). The aim of our study was to compare the efficacy of a combination of ipratropium bromide and fenoterol (Duovent) with the activity of single drugs in the prevention of histamine-induced bronchospasm. Twenty-six atopic asthmatic subjects were examined in a double-blind trial, during an asymptomatic period, with a FEV1 value not lower than 20% of the predicted normal value. During 4 consecutive days all patients received 2 puffs, respectively, of Duovent (200 micrograms fenoterol + 40 micrograms ipratropium bromide), fenoterol (400 micrograms), ipratropium bromide (80 micrograms) and placebo in a randomized order. PD20 values were evaluated after each drug administration: after 2 h in 16 patients and after 5 h in the other 10 patients. The data were modified to log values, and statistical analysis was performed by two-way analysis of variance. This study showed that Duovent and fenoterol have a protective effect against histamine-induced bronchospasm with a significant increase in the PD20 values 2 h (p less than 0.01) and 5 h (p less than 0.05) after treatment when compared to placebo. Duovent inhalation determined a more protective effect than other drugs but not significantly when compared to fenoterol. Some advantages in the modulation of bronchial reactivity could be seen from using Duovent because with the lower dose of the beta 2-adrenergic drug the same results could be obtained without side-effects.

Adolescent↗
PubMed1986

Modulation of non-specific bronchial reactivity.

There are several drugs that can modify non-specific reactivity induced by various stimuli. Disodium cromoglycate (DSCG) is able to reduce bronchial hyperreactivity status, but its mechanism has not yet been demonstrated. It would be expected to exert its activity either by mastocyte stabilization or by other actions that are not related to mastocyte mediator release. It has been suggested that DSCG has a calcium channel blocking activity. Its possible role as a calcium antagonist suggest a general modifying effect of calcium antagonists against hyperreactivity, although their use in therapy cannot be foreseen. In exercise-induced bronchospasm, numerous beta 2-adrenergic drugs have proved more effective than other drugs studied in several investigations. It is unknown whether their effects are to be attributed to a bronchodilator activity or to another mechanism of action. Anticholinergic drugs have a lower protective effect against several stimuli. Theophylline has protective action on histamine bronchospasm which is dependent on the blood levels of theophylline attained. Many drugs currently available can modify bronchial hyperreactivity, but only in a transient way. Several anti-asthmatic drugs cause a decrease of the bronchial hyperreactivity, reducing the release of inflammatory mediators and inhibiting reflex bronchoconstriction. However, at present there are no specific drugs which are able to modify bronchial hyperreactivity with a direct action.

Adrenergic beta-Agonists↗
PubMed1986

Adenosine-induced bronchoconstriction: comparison between nedocromil sodium and sodium cromoglycate.

The purpose of this study was to compare the protective effect of nedocromil sodium with that of sodium cromoglycate against adenosine-induced bronchoconstriction in 15 asymptomatic asthmatic patients. Airways response was evaluated as FEV1 and adenosine was administered as an aerosol diluted in 0.9% saline to produce a concentration range of 0.03-4.00 mg/ml. When FEV1 was decreased by 20% of the post-saline value, inhalation was discontinued and the PD20 adenosine calculated. Patients were studied on four separate days. On the first day the adenosine challenge was performed and on subsequent days patients were pretreated with either placebo or test drug in a randomized double-blind manner. In this study both sodium cromoglycate and nedocromil sodium showed a significant protective effect against adenosine in comparison with placebo. Their activity was not related to a bronchodilator action. Nedocromil sodium showed a greater protective effect against adenosine challenge which may be indicative of a broader spectrum of activity against nonantigenic stimuli.

Adenosine↗