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Biomedical subjects

L Conte

Publications and source records attributed to L Conte.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Emergency angioplasty in high-risk acute infarct].

BACKGROUND: Primary coronary angioplasty in acute myocardial infarction yields superior results in terms of effective vessel patency, recurrent ischemia and acute morbidity, as compared to intravenous thrombolysis. Despite obvious logistic and economic limitations, this early invasive approach could be strictly indicated in selected groups of patients. AIM: A prospective study to test the immediate and short-term results of an early invasive strategy with angioplasty in patients with high-risk acute myocardial infarction. METHODS: Forty-one consecutive patients with high-risk acute myocardial infarction were submitted to coronary angiography and angioplasty of the involved vessel within 12 hours of onset of symptoms. Twenty-eight had anterior myocardial infarction and 6 were in cardiogenic shock. RESULTS: Primary success was achieved in 38 patients (93%): 30 of these were discharged without complications or further revascularization procedures, and none has symptoms or re-infarction at one-month follow-up. CONCLUSIONS: Immediate invasive treatment with angioplasty in high-risk acute myocardial infarction seems to achieve good results, due to both effective infarct vessel recanalization, and early identification of candidates to urgent complete surgical revascularization.

Adult↗
PubMed1995

Effective radiation dose to the patient and to the general population from nuclear medicine procedures: variations in the last twenty-year period.

We have evaluated how changes in nuclear medicine (NM) techniques over the last twenty-year period have modified radiation exposure to the patient and population. For this purpose, we estimated the variations in the mean effective dose to the patient, and both the collective and the per capita effective dose to the population of the province of Varese, derived from radioisotope examinations carried out in the four NM Centers of this province in the years 1972, 1981, and 1991. Dosimetric calculations were based on ICRP Publication 53 for most of the radiopharmaceuticals used, and tissue weighting factors were based on ICRP Publication 60. The total number of NM exams carried out was 19,744 in 1972, 31,973 in 1981, and 23,623 in 1991. Between 1972 and 1991 there has been a substantial decrease in the effective irradiation to the patient and to the general population (mean effective dose to the patient: from 21.2 to 6 mSv; per capita mean effective dose: from 0.58 to 0.18 mSv), and in the per capita equivalent dose to some target organs, such as the thyroid (9.6-->1.5 mSv) and liver (0.51-->0.07 mSv). At the same time, there has been a significant increase in the per capita equivalent dose to the bladder (0.05-->0.48 mSv), skeleton (0.08-->0.36 mSv), and testes (0.02-->0.15 mSv), and a less marked increase to the ovaries (0.03-->0.06 mSv). The per capita equivalent dose to red marrow (0.13-->0.1 mSv) and to the large intestine (0.1-->0.12 mSv) did not change significantly.

Adolescent↗
PubMed1995

[Venereal perihepatitis: Fitz-Hugh-Curtis syndrome].

A case of Fitz-Hugh-Curtis syndrome (venereal perihepatitis) is reported. This syndrome is observed almost exclusively in women as a complication of genital gonococcal or chlamydial infections. A sudden, acute biliary-type pain generally characterizes the disease; only a few cases present symptoms related to associated genital infection. The real clinical incidence of venereal perihepatitis is quite high; in fact, a lot of the emergency admitted patients diagnosed with biliary colic or acute cholecystitis as a matter of fact suffer from this syndrome. If haematological investigations, ultrasonography and cholangiography do not confirm a suspected biliary lithiasis, it will be needed to investigate the genital tract. After clinical and ultrasound examinations, neisseria gonorrhoeae and chlamydia trachomatis must be sought in vaginal and cervical secretions and serum antichlamydial antibodies level is to be sought too. Through these examinations, the venereal perihepatitis can usually be diagnosed. In uncertain cases laparoscopy can be useful: in fact, it can reveal the typical violin-string-like adhesions between the anterior liver capsule and the anterior abdominal wall, and, in the same session, it allow to resect them. Tetracycline, doxycycline and, more recently, ofloxacine gave good results in the syndrome's treatment.

Adult↗
PubMed1994

On-line fully automated solid-phase extraction-liquid chromatography analysis of 1,2-dihydro-4-(1,2-dihydro-2-oxo-1-pyridyl)-2,2-dimethyl-1-oxonaphthale ne-6- carbonitrile (UR-8225), a new potassium channel opener, in plasma samples.

A fully automated reversed-phase HPLC method for pharmacokinetic studies was developed for the determination in plasma samples of 1,2-dihydro-4-(1,2-dihydro-2-oxo-1-pyridyl)-2,2-dimethyl-1-oxonaphtha lene-6- carbonitrile (compound I), a new potassium channel opener. On-line solid-phase extraction was performed with disposable C18 cartridges. After clean up, the samples were eluted and transferred onto an RP-18 analytical column, where separation was performed with a mobile phase of acetonitrile-10 mM di-n-butylamine phosphate (28:72, v/v). Ultraviolet absorbance detection was used at 236 nm. The detector response was linear in the range 25-2500 ng/ml, and the lowest limit of quantitation was determined at 2.5 ng/ml. The inter-day variability was < 4% for samples at 1000 ng/ml and < 15% for samples at 10 ng/ml. This method was used for the pharmacokinetic study of compound I in rats at three different dosage levels.

Animals↗
PubMed1994

[Elective coronary angioplasty in total absence of heart surgery].

BACKGROUND: One-hundred consecutive procedures of elective coronary angioplasty were attempted in 95 patients, in the absence of any surgical stand-by. All patients had angina and/or signs of inducible ischemia. METHODS: All patients and attending physicians were informed that no surgical coverage was available, and gave their consent. The choice was made on the basis of the estimate, on clinical and angiographic grounds, of the consequences of vessel occlusion, of the possible help offered by percutaneous bail-out techniques, and of the applicability of surgical stand-by. RESULTS: A primary success was achieved in 92 cases: in 5 cases a Palmaz-Schatz stent was implanted. In 6 cases the procedure was unsuccessful, with no complications. Two patients sustained a myocardial infarction without new Q-waves. No patient died, nor underwent cardiac surgery within 1 month of discharge. CONCLUSIONS: Our initial experience suggests that, in the absence of surgical stand-by, elective coronary angioplasty can be performed in selected patients at an acceptable risk.

Adult↗
PubMed1994

[Quality assurance and cost control in invasive and interventional cardiology].

We report our experience of Quality Assurance in a Cardiac Catheterization Laboratory of the National Health Service. An attempt was made to apply these criteria to the medical activities as well as to the management and economic aspects of our work. Limits and perspectives of this experience are discussed as a contribution to ongoing debate among cardiologists and public health Authorities.

Costs and Cost Analysis↗
PubMed1993

[Diagnostic hemodynamics in day-hospital care].

Our initial experience with 180 consecutive cases of transfemoral cardiac catheterization in ambulatory patients is presented. It accounts for 21% of 864 diagnostic cardiac catheterization procedures in our laboratory in the first 12 months of activity. There were no complications. Patient satisfaction was high, and a substantial reduction of unnecessary overnight admissions in the cardiology ward could be achieved. This confirms the safety and the advantages of this practice. Implications for the organization of the Catheterization Laboratory are also discussed, as well as possible causes for the sofar limited use of ambulatory cardiac catheterization in our country.

Adolescent↗
PubMed1992

Binding of a metabolite of triflusal (2-hydroxy-4-trifluoromethylbenzoic acid) to serum proteins in rat and man.

2-hydroxy-4-trifluoromethylbenzoic acid (HTB) is the main active metabolite of the platelet antiaggregant drug triflusal. Its binding to plasma proteins of rats and healthy volunteers in vitro and in vivo has been studied. Rats were given a single oral dose of 50 mg.kg-1 triflusal and the healthy volunteers received 300 mg as a single oral dose or a multiple dose regimen of 600 mg every 24 h and 300 mg every 8 h, both for 13 days. Protein-free HTB was obtained by ultrafiltration. Unbound and total HTB concentrations were determined by HPLC. HTB was primarily bound to albumin in plasma. The Scatchard plots suggested two types of binding sites for HTB on the albumin molecule. In rats, the binding constants (K = intrinsic affinity constant, n = number of binding sites) were K1 = 1.4 x 10(5) l.mol-1, n1 = 1.23, and K2 = 4.1 x 10(3) l.mol-1 and n2 = 3.77. The mean plasma concentration in rats after oral administration was 185 (37) micrograms.ml-1 (protein-free HTB:2.44 (0.77)%). The binding constants in human plasma were K1 = 4.7 x 10(5) l.mol-1, n1 = 1.93, K2 = 4.3 l.mol-1 and n2 = 4.28. The plasma HTB concentration in man (n = 8) was 35 micrograms.ml-1 (Cmax) after a single oral dose of triflusal 300 mg, 172.96 micrograms.ml-1 (Cmax.ss) during the multiple dosage regimen of 300 mg every 8 h, and 131 micrograms.ml-1 (Cmax.ss) during the multiple oral dose regimen of 600 mg every 24 h. Unbound HTB ranged from 0.27 to 0.43%, depending on dose.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1992

In-vitro protein binding interaction between a metabolite of triflusal, 2-hydroxy-4-trifluoromethylbenzoic acid and other drugs.

2-Hydroxy-4-trifluoromethylbenzoic acid (HTB) is the main active metabolite of triflusal, an antiplatelet drug. The in-vitro binding of HTB to human serum was studied in the presence of different drugs. The results indicate that no statistically significant changes are observed in the HTB binding in the presence of caffeine, theophylline, glisentide, enalapril, cimetidine or warfarin. The free fraction of HTB increases significantly in the presence of the non-steroidal anti-inflammatory drugs studied: diclofenac, ibuprofen, indomethacin, naproxen, piroxicam and salicylic acid. At high concentrations, HTB displaces these anti-inflammatory drugs and also glisentide and warfarin from their protein binding sites.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1992

Percutaneous absorption and skin distribution of [14C]flutrimazole in mini-pigs.

The percutaneous absorption and skin distribution of a skin cream containing 1% 14C-labelled 1-[(fluorophenyl) (4-fluorophenyl) phenylmethyl]-1H-imidazole (flutrimazole, UR-4056, CAS 119006-77-8) was studied in minipigs. The same dose of flutrimazole was administered i.v. and topically (as a cream) on scarified skin according to a crossover protocol. Samples of urine and faeces were taken at various intervals after administration, and radioactivity was measured. The percentage of radioactivity accumulated in urine after topical and intravenous administration were 1.46% and 41.7%, respectively. In faeces, the percentage of radioactivity observed was 6.0% after intravenous administration, and none was detected after topical application. In order to study the distribution and penetration of [14C]flutrimazole, the cream was applied to intact and scarified skin. At various intervals after administration, skin samples were taken. The samples for the autoradiographic studies were cut transversely, and for the measurement of the levels of radioactivity at different skin depths, slices were cut parallel to the cutaneous layers. The results obtained indicate that [14C]flutrimazole penetrates quickly into the different epidermic layers and is retained mainly in the strata spinosum, granulosum and basale. The stratum basale possibly acts as a selective barrier preventing the penetration of the compound into the dermis. The percentage of radioactivity in the stratum corneum is lower than that detected in all the other epidermic layers taken together. The stratum corneum offers low resistance to penetration by the flutrimazole, which very probably crosses the epidermic strata by a transcellular route.

Animals↗
PubMed1992

Pharmacokinetic study of [14C]flutrimazole after oral and intravenous administration in dogs. Comparison with clotrimazole.

This trial involved a comparative study using 6 Beagle dogs on the pharmacokinetics of 14C-labelled 1-[(2-fluorophenyl)(4-fluorophenyl)phenylmethyl]-1H-imidazole (flutrimazole, CAS 119006-77-8) and [14C]clotrimazole labelled in the imidazole ring. On the basis of a cross-over trial, each animal received a dose of 5 mg/kg (approx. 100 microCi) [14C]flutrimazole and [14C]clotrimazole, both intravenously and orally. The levels in plasma, urine and faeces of the total radioactivity, unchanged drug and the [14C]imidazole formed by metabolization of the unchanged drug were determined. Flutrimazole presented a biological half-life (t1/2) of 14.4 +/- 3.8 h and a clearance (Cl) of 6.7 +/- 0.8 l/h, while the values for clotrimazole were very different: t1/2 4.6 +/- 0.8 h and Cl: 13.6 +/- 1.0 l/h. After oral administration a fraction of absorbed dose (f) of 78 +/- 21% and bioavailability of 8.9 +/- 6.1% were calculated for flutrimazole. For clotrimazole, these were: 52 +/- 10% and 4.9 +/- 1.9%, respectively. Both drugs showed a significant first-pass effect, with 90% of the absorbed dose being metabolized before reaching the systemic circulation. The total recovery of radioactivity in faeces and urine 5 days after i.v. and oral administration was 58% and 68%, respectively, for [14C]flutrimazole, and 81% and 79% for [14C]clotrimazole. In both cases, most of the radioactivity was recovered in the faeces. The high radioactivity obtained in faeces after i.v. administration of both drugs confirms biliary elimination. For both flutrimazole and clotrimazole, less than 1% of the total recovered in the urine after i.v. administration was recovered as unchanged drug.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1991

[Dosimetric study of the applications of intracavitary radiotherapy using a remote-loading device with mobile sources].

This paper deals with the dosimetric aspects of remote-controlled afterloading irradiation devices used in brachytherapy. An afterloading device (Gammamed III) is available at Varese Regional Hospital, for intracavitary radiation therapy (low-dose rate). In the Gammamed afterloading method the radioactive sources contained in an applicator are introduced into the patient's body. This device is based on the principle of stepwise movement of three 137Cs radioactive sources (1.48; 2.96; 1.48 GBq). The results are here presented of a dosimetric study on the correspondence between algorithm for calculating isodose distributions in intracavitary treatment and experimental measurements in a phantom. Doses around the moving source were measured using thermoluminescent LiF-100 dosimeters (1 x 1 x 6 mm). Measurements were taken in a polystyrene phantom. Isodose distributions were estimated by reading the optical density of radiographic films. Doses were found to range around the calculated values within +/- 4% (with thermoluminescent dosimeters) and within +/- 8% (with films). The close agreement between the experimental and the calculated doses confirmed the acceptability of the dose distribution calculation model for the moving sources, and the Gammamed reliability.

Brachytherapy↗
PubMed1990

A new method for calculating the distribution of radioactivity in man measured with a whole-body counter.

A whole-body counter with a scanning bed and two opposite (antero-posterior) probes was used to obtain profiles of count rates of radioactivity held in the whole body. The distribution of the activity in the patient was calculated by solving an overdetermined system (more equations than unknowns) of linear equations with the Chebyshev method, the least-squares method, and an iterative method. The iterative method gave the best results, especially in the case of distributions with peaks of radioactivity. Some in-vivo applications of the method are presented.

Diphosphonates↗
PubMed1990

[Total skin irradiation with electrons for mycosis fungoides: criteria for the choice of technique and experimental dosimetry].

The initial lesions of mycosis fungoides are confined to the skin at a depth of about 1 cm. Wide fields irradiation with low energy electron beams is therefore the treatment of choice for the first stages of the disease. The authors have analysed the various treatment techniques of total skin electron beam irradiation reported in the literature. Dosimetric and practical features are considered. The angled beams technique seems to fit better the needs of a common Radiation Therapy Department. A treatment system with six pairs of 3 MeV electron beams is described and preliminary dosimetric measurements of a similar system that employs 6 MeV electrons are reported.

Electrons↗
PubMed1990

Pharmacokinetics of triflusal after single and repeated doses in man.

Triflusal pharmacokinetics were evaluated in 8 healthy subjects after a single 300 mg dose and after repeated doses of 300 mg every 8 h and 600 mg every 24 h during 13 days, with the aim of establishing a relationship between plasma levels and dosage patterns. Plasma concentrations of triflusal and its main metabolite, 2-hydroxi-4-trifluoromethylbenzoic acid (HTB), were determined by HPLC. Triflusal (t1/2 = 29-35 min) metabolized rapidly into HTB. Four h after the first or last repeated dose administration, triflusal levels could not be detected. After the administration of 300 mg every 8 h, the parameters obtained for HTB were: Cmax-ss = 178 +/- 42 micrograms/ml, tmax-ss = 1.9 +/- 0.7 h, Cmin-ss = 155.6 +/- 41.2 micrograms/ml, Cavg-ss = 168.0 +/- 41.8 micrograms/ml and a t1/2 of 48 +/- 15 h. The parameters obtained for the dosage of 600 mg every 24 h were: Cmax-ss = 153 +/- 40 micrograms/ml, tmax-ss = 2.7 +/- 0.9 h, and a t1/2 of 50 +/- 16 h. No significant differences were observed between the elimination half-life obtained after the single dose and after the two repeated dose regimens studied. This finding suggests that HTB displays a linear pharmacokinetic behaviour.

Adult↗
PubMed1989

[Bacteriologic monitoring in a surgical department with emergency services. Epidemiologic analysis and study of sensitivity to antibiotic therapy].

The two year experience with 2091 biological cultures and the related antibiograms has been reported on the basis of a prospective, computerized study. The incidence of germs coming from each fluid collected has been analyzed as well as the sensibility to various antibacterial drugs. The gram negative such as Escherichia Coli, Enterococcus, Pseudomonas, Proteus, Klebsiella, Serratia and Enterobacter resulted more frequently isolated; in addition a revival of gram positive strains (Staphylococcus, Streptococcus) was noted too.

Bacterial Infections↗