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Biomedical subjects

G Brunetti

Publications and source records attributed to G Brunetti.

At least 37 records · Page 2Linked to original sources
PubMed1992

Spread and distribution of 5-ASA colonic foam and 5-ASA enema in patients with ulcerative colitis.

Rectal treatment with enemas, foams, and suppositories is the most efficient method of delivering an adequate quantity of locally active drugs to the distal colon. In a pilot study carried out by colonoscopy in four patients, it was observed that 4 g 5-ASA in 20 ml foam spread up or beyond the splenic flexure and more extensively than 2 g 5-ASA in 10 ml foam. Therefore we have undertaken a study in order to compare by scintigraphy the colonic distribution of 4 g 5-ASA foam versus 4 g 5-ASA in 100 ml liquid enemas in 10 patients with ulcerative colitis using a crossover randomized design. Both preparations were labeled with 100 MBq [99mTc]sulfur colloid before administration. Anterior scans were taken at intervals for 4 hr. Activity, expressed as a percentage of total radioactivity, was measured in the rectum, sigmoid, descending, transverse, and ascending colon. Six patients had the same extent of spread with the two formulations; in three patients with foam and in one patient with enema a greater spread was observed. The foam reached the upper limit of disease in all cases, while enema failed in two cases. The maximum spread with foam was observed within 30 min in nine of 10 patients compared with seven of 10 after enema. Compared to enema, foam distributes more uniformly and seems to persist longer in the descending and sigmoid colon. The 5-ASA colonic foam shows some more favorable characteristics than enema for the local treatment of left-sided ulcerative colitis.

Administration, Topical↗
PubMed1992

Oral 5-aminosalicylic acid (Asacol) in the maintenance treatment of Crohn's disease.

A randomized, placebo-controlled multicenter trial was conducted to evaluate the efficacy and safety of a delayed-release formulation of 5-aminosalicylic acid (5-ASA) (Asacol; Giuliani & Bracco, Milan, Italy) for prevention of clinical relapse in 125 patients with inactive Crohn's disease. Patients in remission [Crohn's Disease Activity Index (CDAI) less than 150] between 3 months and 2 years were randomly allocated to receive either 800 mg 5-ASA three times daily (n = 64) or placebo (n = 61) for up to 12 months or until relapse of symptoms. Relapse was defined by a CDAI greater than 150, with a minimum increase of 100 points over the baseline value. The cumulative relapse rates were 12% in the 5-ASA group and 22% in the placebo group at 3 months [95% confidence interval (CI) for the difference, -4 to 24]; 28% and 41%, respectively, at 6 months (95% CI, -4 to 30); and 34% and 55%, respectively, at 12 months (95% CI, 3-39; P = 0.02, log rank test). Significant decrease in the risk of relapse was found in patients with ileitis, in those with previous bowel resection and, in those with prolonged prestudy remission. Eight patients (5 on 5-ASA, 3 on placebo) withdrew from the study because of adverse reactions, but no major clinical or laboratory adverse effect was observed. It is concluded that oral 5-ASA coated with Eudragit S (Rohn Pharma GmbH, Wieterstadt, Germany), 2.4 g daily, is safe and seems superior to placebo in preventing or delaying clinical relapse in Crohn's disease, especially in milder cases and in ileal disease.

Adolescent↗
PubMed1990

Topical treatment with 5-aminosalicylic in distal ulcerative colitis by using a new suppository preparation. A double-blind placebo controlled trial.

Sixty-two patients with ulcerative colitis localised to the distal sigmoid colon and rectum (less than 20 cm) entered the trial. Thirty-two were treated with 5-ASA 500 mg suppositories (Asacol) 3 times a day for 1 month while 30 received a placebo given in the same regime. Clinical, sigmoidoscopic and histological assessment was carried out before, after 15 days and after 1 month of treatment. At the end of the study 5-ASA suppositories showed significantly better results in all the parameters recorded than placebo (p less than 0.01). There were no unwanted effects related to the use of suppositories. This treatment should therefore be offered as a first choice for patients with distal rectosigmoiditis.

Adult↗
PubMed1990

Comparison of a new colon lavage solution (Iso-Giuliani) with a standard preparation for colonoscopy: a randomized study.

Iso-Giuliani is a new improved-taste isoosmotic PEG-electrolyte solution for colon cleansing. In a randomized study, we have compared the effectiveness, tolerance and patient acceptance of 3 dosage volumes of this solution with a standard preparation in 191 patients undergoing colonoscopy. Iso-Giuliani 3 1, and 4 1 proved better colonic preparations as compared with the standard preparation (P less than 0.01). However Iso-Giuliani, 21 was sufficient for satisfactory cleansing, especially in the rectosigmoid. Patients in the standard preparation group experienced more cramps than did those in Iso-Giuliani groups. Patient acceptance was significantly better for Iso-Giuliani than for the standard preparation. The ingestion of Iso-Giuliani represents a safe, effective and well-accepted method of colon cleansing, and is our elective method of preparation for colonoscopy.

Administration, Oral↗
PubMed1990

Mesalazine (5-aminosalicylic acid) suppositories in the treatment of ulcerative proctitis or distal proctosigmoiditis. A randomized controlled trial.

A multicentre double-blind study was conducted to evaluate the efficacy and tolerability of 1 g or 1.5 g mesalazine daily compared with placebo in 94 patients with mild to moderate distal proctosigmoiditis (less than 20 cm). The study end point was the determination of clinical, endoscopic, and histologic remission rates at 4 weeks. Eleven patients, nine receiving placebo and two receiving 1.5 g mesalazine, withdrew during trial, mostly because of worsening of symptoms. At 4 weeks clinical remission was achieved in 7 of 31 (39%) patients with placebo, in 22 of 32 (69%) patients in the 1 g mesalazine group, and 23 of 31 (74%) patients in the 1.5 g mesalazine group. No serious clinical or biochemical side effect of treatment was reported. Mesalazine suppositories are safe, well tolerated, and very effective in patients with active distal proctosigmoiditis: 500 mg twice daily appears a suitable dose regimen.

Adult↗
PubMed1990

[Non-occupational lead poisoning in home environment].

A case of non professional lead poisoning is described in a baker complaining of abdominal pain and anaemia. No organic alterations in the gastrointestinal and haemopoietic systems were observed. The diagnosis was confirmed by alterations in porphyrin metabolism and by increased blood and urine lead levels, especially after EDTA. The cause of intoxication was attributed to an abnormal lead intake during spray painting in a closed environment a few days before the onset of symptoms.

Diagnosis, Differential↗
PubMed1989

[Meleney's postoperative gangrene].

The authors report the case of a 40 years old man undergoing MOPP chemotherapy for stage III Bb type 2 Hodgkin's disease with immune depression. Six years later he developed two episodes of unilateral transient loss of vision and severe stenosis of the left common carotid artery was found leading to surgical reimplantation of the left subclavian artery. Quickly spreading cutaneous necrosis was observed 5 days after surgery on the scar and the irradiated area: Meleney's postoperative gangrene, an unusual and frequently fatal complication of unknown cause. The patient recovered in two months after wide excision of the necrosed tissues and a skin autograft.

Adult↗
PubMed1988

[Decrement of respiratory function indices in a case series of workers exposed to cement dust: a longitudinal study].

Longitudinal changes in some respiratory parameters (FEV1 and VC) have been examined in a sample of cement workers (163 male subjects differently exposed to cement dusts); the subjects have been surveyed over a period of 10 years performing yearly spirometric tests (Vital capacity--VC and Forced Expiratory Volume in 1 second--FEV1 measurements). Three possible risk indicators have been considered: occupational exposure, smoking habit and age. 65.6% and 60.7% of the cases showed significant individual annual decreases of VC and FEV1 throughout the time of follow up. According to our results the occupational risk indicator has not significantly influenced the normal trend of decreases of the respiratory parameters; instead age brings about an increase of longitudinal changes of VC and smoke habit an increase of longitudinal changes of FEV1, (but only in the younger group, people less than forty years old). 16 subjects characterized by abnormal losses (more than 100 ml/year) have been selected as "VC-FEV1, losers".

Adult↗
PubMed1986

[Digital microembolism disclosing intracardiac thrombosis].

The authors report the observation of a 46 year old man with a case history of myocardial infarction at the age of 26 years, transient ischemic injury at 41 years of age, and in whom a focalised digital ischemic syndrome of microembolic nature led to the discovery of an intracardial thrombosis which was operated upon and progressed without complication. Bloody microembolisms of cardiac origin may be selectively revealed by acrosyndromes, the diagnostic elements of which are mentioned. They are poorly understood conditions. Their significance must not be neglected because of the risk of recurrence in macroembolic form. The pathogenesis of these obstructions and their specific responsibility for ischemic cardiopathies is reviewed. It is appropriate to emphasise the novelty of this observation since, in the context of ischemic cardiopathies, no attention has been devoted to microembolisms, in contrast to the numerous publications relating to macroembolisms. The symptomatic treatment is unremarkable, the etiological treatment of intracardial thrombosis is discussed.

Adult↗
PubMed1984

Oesophageal function after oral ranitidine: an acute double blind study in normal subjects.

The effect of oral ranitidine on oesophageal peristalsis, LOS basal pressure and gastro-oesophageal acid reflux, was investigated in 6 healthy men in a double-blind randomized study. Simultaneous manometry and pH measurements were performed twice in each volunteer during a five hour study period which included the administration of a standard meal. Ranitidine did not affect the motor parameters studied (amplitude, duration and velocity of the peristaltic waves and LOS basal tone), whereas it almost abolished acid gastroesophageal reflux. Our results show that ranitidine, like cimetidine, does not alter the motor function of the oesophagus, while it virtually abolishes acid gastro-oesophageal reflux in normal man.

Administration, Oral↗