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Biomedical subjects

M Galeone

Publications and source records attributed to M Galeone.

At least 19 recordsLinked to original sources
PubMed2004

Effect of desflurane/remifentanil anaesthesia on glucose metabolism during surgery: a comparison with desflurane/epidural anaesthesia.

BACKGROUND: The aim of this study was to investigate the effect of general anaesthesia combined with remifentanil or epidural blockade on glucose metabolism during surgery. METHODS: We randomly assigned patients undergoing elective colorectal surgery to receive either desflurane anaesthesia supplemented with intravenous remifentanil (n = 7) or desflurane anaesthesia supplemented with epidural bupivacaine (n = 7). Plasma concentrations of glucose, lactate, free fatty acids (FFA), insulin, glucagon and cortisol were measured before and after 2 h of surgery. Pre- and intraoperative whole body glucose production and glucose clearance, an indicator of glucose uptake, were determined by an isotope dilution technique using [6,6-2H2]glucose. RESULTS: In both groups intraoperative glucose production ( P< 0.05) and uptake ( P< 0.05) decreased. Plasma glucose concentrations ( P< 0.05) increased during surgery but did not exceed the normal range (remifentanil group: 5.7 +/- 0.7 mmol l-1, epidural group: 5.8 +/- 0.4 mmol l-1). The plasma concentrations of lactate, FFA, insulin and glucagon remained unchanged during the operation. The plasma cortisol concentration in both groups increased intraoperatively (P< 0.05). CONCLUSION: Both desflurane/remifentanil and desflurane/epidural anaesthesia decrease the intraoperative rate of whole body glucose production, thereby attenuating the hyperglycaemic response to colorectal surgery.

Adult↗
PubMed2003

Anaesthetic management of a child with Pallister-Killian syndrome.

Pallister-Killian syndrome is characterized by tetrasomy of the short arm of chromosome 12p, which produces mental retardation of varying degrees and dysmorphic characteristics. We describe anaesthesia in a 2-year-old child affected by this syndrome who underwent surgery for orchidopexy. Anaesthetic consisted of an inhalation mixture of O2, N2O and sevoflurane, together with an inguinal block with ropivacaine and administration of alfentanil plus ketorolac. Tracheal intubation was uneventful. No complications of any type were observed.

Abnormalities, Multiple↗
PubMed1999

[The topical therapy of ulcerative colitis. A multicenter study with beclomethasone dipropionate foam].

BACKGROUND AND AIMS: The use of steroids was recently extended to the various forms of ulcerative rectocolitis by the introduction of topical formulations, above all steroids with an hepatic "first pass" devoid of systemic interference. The aim of this study was to evaluate the efficacy and tolerability of Beclomethasone dipropionate (BDP) in a rectal foam formulation, in the treatment of patients suffering from ulcerative colitis. METHODS: The experimental protocol took the form of a 28-day open prospective trial using BDP rectal foam in patients suffering from ulcerative colitis. Endoscopic, histological, clinical and tolerability parameters were evaluated. The centres taking part in the trial collected data for 60 cases out of a total of 80 patients enrolled in the study, of both sexes and aged between 20 and 81 years old, suffering from proctosigmoiditis (46.7%) and ulcerative rectocolitis (53.3%). RESULTS: Endoscopic parameters showed an improvement after 28 days of treatment in 74.5% of patients; a clinical improvement was achieved in 65.2% of cases. In percentage terms of the mean value of all the improved parameters, histological parameters were altered in 56.9% of patients. With regard to tolerability 82% of patients judged the treatment to be good/excellent. CONCLUSIONS: In conclusion, in line with recent reports regarding other pharmaceutical forms of BDP, including the use of rectal foam, these data confirm the efficacy and tolerability of this molecule and emphasise the validity of its use in the treatment of ulcerative colitis and proctosigmoiditis.

Administration, Topical↗
PubMed1999

[Topical beclomethasone dipropionate (BDP) in intestinal inflammatory diseases: the results of a multicentre trial].

The authors assessed the efficacy and tolerability of BDP in an open protocol using rectal enemas and suppositories and in a double-blind protocol vs mesalazine using rectal enemas. A total of 47 patients suffering from ulcerous rectocolitis were enrolled in the study and treated for 42 days while undergoing endoscopic, histologic and clinical controls. In conclusion, the authors affirm that BDP may represent a useful new therapeutic instrument in the treatment of slight to moderately severe forms of inflammatory intestinal disease.

English Abstract↗
PubMed1991

[Acute cholecystitis associated with calculosis of the biliary tract in a high-risk patient. Combined emergency surgical and peroperative endoscopic treatment].

Patient age (over 65), and lithiasis of the common bile duct are two factors which increase the morbidity and mortality rate in emergency surgery for biliary lithiasis. Normally, calculi in the CBD can be cleared by means of supraduodenal or transduodenal access. In both cases, however, complications are frequent in high risk patients. Treatment of gallstones can be modified to achieve a reduction in the morbidity and mortality rate. This study presents an initial survey of 4 elderly patients, presenting with acute gallbladder disease and CBD stones, treated with surgical cholecystectomy and contemporary perioperative endoscopic papillotomy and CBD clearance. The underlying rationale and the good initial results support this combined surgical and endoscopic approach.

Aged↗
PubMed1990

Prostaglandin-stimulated recovery of the human duodenal epithelium: effects of misoprostol on ethanol damage.

This study was designed to determine whether prostaglandins can stimulate the repair of human duodenal epithelium. Ten healthy volunteers were given 50 ml 40% ethanol through an endoscope onto the duodenal mucosa 1-7 cm from the pyloric sphincter; 3 min later, misoprostol (200 micrograms) or inert vehicle (5 ml) was given locally in the same way. One and 5 h later, endoscopy was repeated to evaluate the damage. The conditions of the mucosa were evaluated by endoscopy and by scanning and transmission electron microscopy in biopsies taken at time 0 and 3 min, 1 and 5 h after ethanol. The study was double-blind with a cross-over balanced design. Three minutes after ethanol administration, the duodenal mucosa showed hyperemia with hemorrhagic lesions. Under the electron microscope, the lesions were caused by vascular engorgement or red blood cell extravasation into the submucosa; the epithelium underlining lesions showed loss of superficial cells and damage to the upper layer of the mucosa. One hour after ethanol, there was a striking difference between the two treatment groups, with a substantial recovery of the duodenal epithelium in the misoprostol-treated volunteers. Although spontaneous recovery was evident in the control group, there was also a significant difference at 5 h. Our results suggest that prostaglandins are able to stimulate the recovery of the duodenal epithelium after acute damage.

Alprostadil↗
PubMed1988

Haemorheological effects of fructose-1,6-diphosphate in patients with lower extremity ischaemia.

A prospective, single-blind study was carried out in 30 patients with obstructive peripheral artery disease to investigate the haemorheological properties of fructose-1,6-diphosphate (FDP). Patients were allocated at random to receive 7 to 10-days' treatment with either 10 g or 10% FDP twice daily or saline. Measurements were made on entry and at the end of treatment of whole blood and plasma viscosity, erythrocyte deformability and aggregation, and lower limb blood flow was evaluated by Doppler technique. FDP treatment was associated with a reduction in whole blood viscosity (24%) and red blood cell aggregation index (27%), and an improvement in red blood cell deformability (42%) (p less than 0.01). No significant changes were observed in the control group. Plasma viscosity did not change in either treatment group. Limb blood flow increased (p less than 0.05) only in patients treated with FDP; the improvement was more pronounced in the most severely affected side (30%). No untoward events were observed or reported in any of the patients studied.

Aged↗
PubMed1988

Prostaglandin cytoprotection in man: effectiveness of rosaprostol.

We studied the effect of a new prostaglandin analogue, 9-hydroxy-19,20-bis-norprostanoic acid (rosaprostol), on the duodenal mucosa of humans after administration of 40% ethanol. Eighteen healthy volunteers entered the study, which followed a blind cross-over design. At time 0 all the volunteers received rosaprostol or placebo; 5 minutes later, 40% ethanol (50 ml dose) was given. The mucosa was examined for lesions 3, 60 and 180 min later under endoscopy, light and scanning microscopy. It was found that: (i) 40% ethanol damaged the duodenum, with blood extravasation, inflammation and necrosis of the mucosa, (ii) rosaprostol significantly protected the mucosa 3 min after 40% ethanol, and (iii) the damage became worse after 3 h when placebo was given, whereas it was reduced after 1 h when PG was administered. The results suggest that PGs not only protect the mucosa against ethanol damage, but also stimulate its recovery.

Adolescent↗
PubMed1987

Cardiotoxicity during chemotherapy for advanced gastroenteric tumors.

The authors report two cases of patients with advanced gastroenteric carcinoma, which developed different cardiotoxicity patterns after the administration of cytotoxic drugs. The first patient showed a picture of dilatative cardiomyopathy with associated symptoms of angina pectoris and congestive heart failure; the second patient presented a cardiac arrhythmia after several administrations of 5-fluorouracil. The possible mechanisms of these toxic effects, as well as the drug interactions are briefly discussed. Cardiotoxicity of cytotoxic drugs should be considered by oncologists even in patients with no previous history of cardiac disease.

Adult↗
PubMed1986

[Clinical and instrumental evaluation by multiple colonic manometry of tiropramide, trimebutine and octylonium bromide in irritable colon. II. Repeated oral administration].

Sixty out-patients with acute or sub-acute irritable colon were randomly allocated to receive 3 daily doses of 100 mg tiropramide, 150 mg trimebutine maleate or 20 mg octilonium bromide, orally during 5 consecutive days. Before and after treatment, multiple colonic manometry was performed, monitoring tonus, intensity and frequency of sinusoid contraction waves, transitories and vibrations, as well as the voluntary contraction capacity. Before treatment and after 2 and 5 days, the specific symptoms were also monitored, scored and recorded. Significant variations in tonus were not observed with any drug, but while tiropramide left unmodified the voluntary contractile ability, a significant inhibition was observed with trimebutine and, mainly, with octilonium. The overall power of spontaneous colonic contractions did not vary significantly with any drug. However, while with tiropramide a significant redistribution of muscular power was observed so as to increase propulsion waves and to decrease the ineffective transitory and vibrational contractions, with octilonium and trimebutine no clinically relevant redistribution of the power wasted in transient spasms was observed. Based on these observations, tiropramide was considered to be at least as effective an antispasmodic as octilonium and at least as effective a synchronizer as trimebutine, but was different from both reference drugs because it was the only one to act simultanously as both an antispasmodic and a synchronizer. The three drugs produced an improvement in each and all monitored symptoms as well as in the overall symptom intensity. Tiropramide, however, produced an improvement significantly faster, more progressively and to a greater extent than either reference drug.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1986

Adaptive cytoprotection: an endoscopic study in man.

We studied the protective effect of the mild irritant 20% ethanol against the damage caused by the strong irritant 40% ethanol to the duodenal mucosa of 10 healthy volunteers. At time 0, placebo (1% ethanol) or 20% ethanol (6 ml) was sprayed directly onto the duodenal wall through an endoscope. After 15 min 40% ethanol (50 ml) was given; damage was assessed by endoscopic examination 30 min after ethanol. The damage was scored arbitrarily: score 0, no damage; 1, duodenal hyperemia; 2, one hemorrhagic lesion; 3, two to five hemorrhagic lesions; 4, five hemorrhagic lesions. In separate experiments, the effect of acetylsalicylic acid (20 mg/kg iv) on adaptive cytoprotection was evaluated. It was found that 1) 20% ethanol does not damage the duodenal mucosa, whereas 40% ethanol does; 2) duodenal hyperemia and hemorrhagic lesions caused by 40% ethanol can be prevented by the previous administration of 20% ethanol; and 3) acetylsalicylic acid does not damage the duodenal mucosa but abolishes the protective effect of 20% ethanol. "Adaptive cytoprotection" is a physiological phenomenon in humans too and further supports the probable defensive role of endogenous prostaglandins in the gastrointestinal tract.

Adolescent↗
PubMed1986

[Clinical and instrumental evaluation by multiple colonic manometry of tiropramide, trimebutine and octylonium bromide in the irritable colon: I. Administration by single i.v].

Sixty out-patients with acute or sub-acute irritable colon were randomly allocated to receive a single intravenous dose of 50 mg tiropramide, 50 mg trimebutine maleate or 10 mg octilonium bromide. Before and after injection, multiple colonic manometry was performed, monitoring tonus, intensity and frequency of sinusoid contraction waves, transitories and vibrations, as well as the voluntary contraction capacity. Significant variations in tonus were not observed with any drug, but, while tiropramide left unmodified the voluntary contractile ability, a significant inhibition was observed with trimebutine and octilonium. The overall power of spontaneous colonic contractions did not vary significantly with tiropramide, whereas some decrease was observed with trimebutine, and a substantial one with octilonium. Moreover, while with tiropramide and, to a lesser extent, with trimebutine there was a significant redistribution of muscular power so as to increase phasic propulsion waves and to decrease the ineffective transitory and vibrational contractions, with octilonium only a decreased wave amplitude was recorded without alteration of the frequency of transient spasms. Based on these observations, tiropramide was evaluated as being at least as effective an antispasmodic as octilonium and at least as effective a synchronizer as trimebutine, while setting itself aside from both reference drugs as it was the only one to act contemporarily as both an antispasmodic and a synchronizer.

Adult↗
PubMed1985

[The use of syntropium bromide as an antispasmodic].

The following trials were carried out to evaluate the antispasmodic effect of sintropium bromide in a group of 30 patients. The antispasmodic effect on the gastroduodenal system was observed endoscopically. The results were compared by means of double blind tests carried out using placebo and rociverine. The effect in a group of 10 patients was examined by X-ray of the digestive tract. The effect on another group of 20 patients suffering from abdominal colic was clinically evaluated. Sintropium bromide has a prompt anticholinergic action and for this reason may be used in the treatment of painful conditions of the bile, gastro-enteric and renal tracts, and also during the course of endoscopic examinations.

Bridged Bicyclo Compounds↗
PubMed1985

The use of antisera ('Serocytol') in the management of gastritis: a double-blind clinical assessment versus placebo.

A double-blind, placebo-controlled study was carried out in 40 out-patients with endoscopically confirmed hypertrophic or erosive gastritis, without ulcer, to assess the effectiveness and tolerance of treatment with equine antisera (antidiencephalon and anti-stomach tissue). Patients were assigned at random to receive a single dose in suppository form on 2 days a week for 6 weeks of both antisera (anti-diencephalon on Days 1 and 4, anti-stomach tissue on Days 2 and 5) or placebo (saline solution). No other anti-ulcer treatment was allowed except standard antacid tablets, the consumption of which was recorded and used as an evaluation parameter. Endoscopy, haematology and haematochemistry were performed before and after treatment; symptoms (daytime and night-time pain, heartburn and dyspepsia) and possible adverse reactions were scored 0 to 4 in order of increasing severity before treatment and after 1, 2, 4 and 6 weeks. Five patients in the placebo group had to be withdrawn from the trial at the second week because of therapeutic failure. This proportion was significantly in favour of the antisera group, as was the proportion of patients endoscopically healed and the extent and rate of symptomatic improvement. Concomitant antacid consumption rapidly and significantly decreased in the antisera but not in the placebo group. Signs of intolerance were not observed with either treatment, nor were there any significant alterations in haematology or haematochemistry. In particular, the immune titre of patients did not increase after treatment, thus indicating that the administered heterologous proteins did not elicit an immunization of the patients against horse protein.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Beta-blockers and psychic stress: a double-blind, placebo-controlled study of bopindolol vs lorazepam and butalbital in surgical patients.

One hundred patients scheduled for surgery participated in a randomized double-blind trial designed to evaluate the effects of acute treatment with two doses of bopindolol (1 mg:BP1;2 mg:BP2) in comparison with those of 2.5 mg lorazepam (LR), 75 mg butalbital (BT) and placebo (PL). Anxiety was evaluated by the STAI X1 questionnaire on the day before surgery, in the late afternoon (time 0: basal) and in the evening (time 1). At the same times patients were requested to play a game of manual skill called "Go Down". The next day, in the morning (time 2), the patients were given the same questionnaire and were asked a series of questions about their sleep and awakening. Mean anxiety scores were significantly increased over basal values at both time 1 and time 2 in the PL and LR groups and at time 2 in the BT group, but neither in the BP1 nor in the BP2 group. The time needed to perform the "Go Down" test was significantly shorter than the basal value for both BP groups and significantly longer for the BT group, while nonsignificant modifications occurred in the PL and LR groups. Positive effects were obtained in patients treated with BP, at both doses, on ease of "falling asleep", number of "night awakenings" and "reawakening mood" while LR and BT were mostly ineffective, except for BT on ease of "falling asleep". It was concluded that a beta-blocker such as bopindolol may be more effective than a benzodiazepine or a barbiturate for the prevention of anxiety symptoms induced by a clearly defined stress situation, such as awaiting a surgical operation.

Adrenergic beta-Antagonists↗