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Biomedical subjects

M Gentili

Publications and source records attributed to M Gentili.

At least 19 recordsLinked to original sources
PubMed2005

Effect of neurolytic nerve block on systemic carrageenan-induced inflammatory response in mice.

BACKGROUND: Local tissue inflammation caused by injury or inflammatory processes may be reduced by section or local anaesthetic block of the nerve innervating the inflamed area. METHODS: Using a neurolytic nerve block, we assessed the systemic inflammatory response elicited by a local injection of carrageenan in mice. Sixty mice received a unilateral sciatic nerve block with 70% ethanol followed 5 days later by an injection of carrageenan on the ipsilateral or contralateral hind paw. Whole blood was sampled 15 h after carrageenan injection. RESULTS: Fifty-six animals had a complete nerve block. Tumour necrosis factor-alpha (TNF-alpha), interleukin 1beta (IL-1beta) and interleukin 10 (IL-10) concentrations were measured in the plasma of 20 mice (10 in the ispilateral group and 10 in the contralateral group). In the remaining 36 mice (18 in each group), blood was cultured for 24 h in the presence of lipopolysaccharide or Staphylococcus aureus extract. TNF-alpha and IL-1beta production in the supernatant were, on average, 30% lower in the ispilateral group than in the contralateral group. CONCLUSION: A prolonged nerve block decreases the systemic consequences of the local inflammatory reaction elicited by carrageenan injection.

Anesthetics↗
PubMed2001

Reproductive assistance to HIV-discordant couples--the German approach.

An estimated 35 000 Germans are infected with HIV, and 75% of these are of childbearing age. Couples with one infected partner are faced with the risk of infection of the healthy partner. By using assisted reproduction techniques (ART) and virus-free sperm it is possible to fulfil the desire for children while minimising the risk of acquisition of infection. Therefore since 1991 in Germany ART is offered to couples of HIV-positive males and seronegative females. However, established programmes in different centres were temporarily suspended due to serious doubts about the reliability and safety of the sperm preparation technique (density gradient centrifugation and swim-up). -. Since 1997 processed sperm samples are routinely tested for HIV by highly sensitive detection methods and cryopreserved. Only if the test is negative are the processed spermatozoa used for homologous insemination, in-vitro fertilization or intracytoplasmatic sperm injection. This procedure removes most medical as well as legal considerations. At present 3 reproductive units in Germany offer reproductive assistance to HIV-discordant couples, and a further 9 institutions plan to establish that procedure. From 1991 to 1999, 54 women were treated by ART. 30 pregnancies occurred and 24 children were born. So far no maternal or infant infection was observed after treatment.

Female↗
PubMed2001

Distinct expression of endothelin receptor subtypes A and B in luteinized human granulosa cells.

Endothelins (ET) are potent vasoconstrictive peptides originally isolated from vascular endothelial cells. Their biological effects are mediated through two different receptors, the endothelin-1 (ET-1)-selective endothelin receptor subtype ETA and the non-selective receptor subtype ETB. ET-1 protein has been found in human ovarian follicular fluid and ET-1 mRNA expression has been demonstrated in ovarian tissue. These findings indicate that the endothelin-system participates in the modulation of ovarian function, probably acting in an autocrine/paracrine manner. In the current study we used freshly aspirated, luteinized human granulosa cells (hGC) representing an in vitro model of the early corpus luteum. By means of RT-PCR and immunocytochemistry we investigated whether luteinized human granulosa cells express ETA and ETB receptors. Specific amplification products of ETA transcripts were detected in all samples investigated. In contrast, only after using a three-fold amount of ETB reverse transcripts we were able to demonstrate specific, but weak amplification products. In addition, immunocytochemical staining for ETA but not for ETB was found in granulosa cell preparations. The present study provides clear evidence that human granulosa cells predominantly express ETA receptor subtype mRNA and protein hinting to its possible role in follicle maturation and corpus luteum formation.

Corpus Luteum↗
PubMed1999

Adding clonidine to lidocaine for intravenous regional anesthesia prevents tourniquet pain.

UNLABELLED: Tourniquet pain often complicates the use of the pneumatic tourniquet during surgical procedures performed under IV regional anesthesia. Clonidine-containing local anesthetic solutions have better analgesic properties than plain solutions when used for spinal, epidural, or peripheral blocks. We tested the hypothesis that the addition of clonidine may improve the quality of IV regional anesthesia, especially tourniquet tolerance. Forty patients were allocated randomly in a double-blinded, randomized study to receive 40 mL of 0.5% lidocaine and either 1 mL of isotonic saline or clonidine (150 microg). A double-cuffed tourniquet was kept inflated until patients complained of pain, leading to release of the distal cuff. Pain at the tourniquet site, at the surgical site, and in the distal part of the arm was rated on a visual analog scale (VAS) and a verbal rating scale (VRS) every 15 min during tourniquet placement and every 15 min for 1 h after tourniquet deflation. Motor blockade, sedation, arterial pressure, and heart rate were also recorded. VAS and VRS scores were significantly lower in the clonidine group 30 and 45 min after tourniquet inflation. The tolerance for the distal tourniquet was also significantly longer in the clonidine group (median [range]: 22 [10-40] vs 10 [5-20] min; P < 0.05); motor blockade was comparable between the two groups. Pain was not different in the two groups after tourniquet release. The clonidine group experienced a higher degree of sedation. We conclude that clonidine improves tourniquet tolerance when added to a local anesthetic solution. IMPLICATIONS: A 150-microg dose of clonidine added to lidocaine improved tourniquet tolerance during IV regional anesthesia.

Adrenergic alpha-Agonists↗
PubMed1998

[Total spinal anesthesia after posterior lumbar plexus block].

We report a case of total spinal anaesthesia which occurred after a lumbar plexus block using a posterior approach. After total hip arthroplasty under general anaesthesia, a lumbar plexus block was performed according to Winnie's landmarks at the L4 interspace using a nerve stimulator. Aspiration test for blood and spinal fluid were both negative, as well as a test dose of 3 mL lidocaine 2%-bupivacaine 0.5%. One minute after the injection of 27 mL of the same mixture, a complete anaesthetic block occurred with hypotension and loss of consciousness requiring intubation and controlled ventilation during 3h30, without sequelae. Lumbar plexus block using a posterior approach must be performed cautiously and a slow and fractionated injection of the full dose is recommended.

Aged↗
PubMed1998

Sedation depends on the level of sensory block induced by spinal anaesthesia.

We have investigated the relationship between the extent of spinal block and occurrence of sedation. In a first series of 43 patients, the distribution of sedation score (measured on the Ramsey scale) was related to the extent of spinal block (pinprick). In a second series of 33 patients, the relationship between sedation score and spinal block persisted after injection of midazolam 1 mg. This study confirmed that high spinal block was associated with increased sedation.

Adolescent↗
PubMed1998

Dot immunobinding assay for detection of mite antigens in house-dust samples.

A new test was developed specifically to detect mite antigens in house-dust. It uses a nitrocellulose dipstick spotted with specific antimite antibodies that act as a capture matrix; the same antibodies act as a detecting reagent when conjugated with colloidal dye particles. Aclotest is a 1-step assay, where a spotted dipstick is placed in a tube containing the detecting reagent and the house-dust sample. No instrumentation or previous extraction procedure of the sample is required, and the test response is visible as a colored spot, after 1 h incubation. The sensitivity and specificity of the new test were compared with those of Acarex and Der p1/Der f1 ELISA tests.

Animals↗
PubMed1998

Localization of the mRNA for the angiotensin II receptor subtype 2 (AT2) in follicular granulosa cells of the rat ovary by nonradioactive in situ hybridization.

The ovary is one of the organs in which an intrinsic renin-angiotensin system (RAS) has been described. Among angiotensin II receptors, the angiotensin II receptor subtype 2 (AT2) is believed to play an important role in mediating or modulating a variety of intraovarian processes. Previous studies were mainly based on ligand binding techniques using AT2 receptor-specific antagonists. Despite the recent cloning of the AT2 gene, no information is available about the exact intraovarian distribution of AT2 mRNA expression. Therefore, we analyzed ovaries from sexually mature, untreated rats by nonradioactive in situ hybridzation using an AT2-specific anti-sense RNA probe. Experiments were performed on perfusion-fixed ovaries obtained from different stages of the estrous cycle. As an important finding, strong AT2 mRNA expression could be demonstrated exclusively in follicular granulosa cells. Follicles containing AT2 mRNA-positve granulosa cells were mainly in the advanced tertiary stage of follicular development, already exhibiting features of atresia. In addition, individual collapsed, definitive atretic follicles also showed strong AT2 mRNA expression solely in granulosa cells. In corpora lutea and in other structures of the ovary, no message for the AT2 receptor could be detected under these conditions. These data may contribute to a better understanding of the effects exerted by an intraovarian RAS. (J Histochem Cytochem 46:865-870, 1998)

Angiotensin II↗
PubMed1997

Intra-articular morphine and clonidine produce comparable analgesia but the combination is not more effective.

Both intra-articular morphine and clonidine produce analgesia. This study was designed to compare the analgesic effects of the two drugs, used separately and in combination. We studied 90 patients undergoing arthroscopy of the knee under general anaesthesia. Patients were allocated randomly to receive 20 ml of intra-articular isotonic saline solution containing morphine 2 mg, clonidine 150 micrograms or both. Pain was assessed on an visual analogue scale after operation and time for rescue medication was measured. There was no difference in VAS scores between the three groups and the time for rescue analgesic was comparable. We conclude that intra-articular morphine and clonidine have comparable analgesic effects in the doses used. The combination of both drugs did not seem to increase analgesia.

Adolescent↗
PubMed1996

Peripheral analgesic effect of intra-articular clonidine.

Sympathetic nervous system stimulation, which releases noradrenaline, influences the nociceptor activity which develops after tissue injury. The alpha 2-adrenergic agonist, clonidine, produces analgesia through a central mechanism but also inhibits noradrenaline release at terminal nerve fibre endings. Clonidine may induce analgesia when administered at peripheral sites. This study assesses the potential analgesic effect of clonidine after intra-articular administration. Forty ASA I-III patients, scheduled for arthroscopic knee surgery under general anaesthesia were allocated randomly in 4 groups of 10 patients each, at the end of the surgical procedure. In the control group (group 1), the patients received 20 ml of intra-articular isotonic saline. In group 2, the patients received 150 micrograms of clonidine diluted in 20 ml of isotonic saline injected into the knee joint. In group 3, the patients were given 20 ml of intra-articular isotonic saline and clonidine 150 micrograms was injected subcutaneously. In group 4, morphine 1 mg, diluted in 20 ml of isotonic saline, was injected into the knee joint. Postoperative pain was assessed in a double-blind fashion using a visual analogue scale (VAS) at 1, 2, 3, 6 and 24 h after the end of surgery. VAS scores were significantly lower in groups 2 and 4, compared to groups 1 and 3, at 1 and 2 h after surgery. The delay between intra-articular injection and further postoperative analgesic administration was significantly longer (P < 0.05) in group 2 (533 +/- 488 min) compared to groups 1 and 3 (70 +/- 30 min and 132 +/- 90 min, respectively). The difference was not significant between group 4 (300 +/- 419 min) and the other groups. We conclude that a low dose of intra-articular clonidine produces analgesia unrelated to vascular uptake of the drug. This study further supports a peripheral analgesic effect of clonidine.

Adrenergic Agents↗
PubMed1996

Comparison between outdoor and indoor airborne allergenic activity.

BACKGROUND: Allergenic pollens are usually detected in outdoor air by using volumetric spore traps, which allow measurement of atmospheric concentration as pollen grains per m3 of air. The results of the pollen count are useful primarily for outdoor environments while most people spend most of the day indoors. OBJECTIVE: The purpose of our study was to compare outdoor pollen levels with allergenic activity measured both outdoors and indoors. METHODS: We used a Lanzoni spore trap to measure airborne Urticaceae pollen and filters collecting particles simultaneously indoors and outdoors and assayed each filter for Parietaria judaica allergenic activity. Samples were collected at the Allergological Service of the "A. Cardarelli" Hospital in Naples with the balcony open on some days and closed on others. Allergenic activity (ng/m3) was measured using the immunocapture RAST. RESULTS: With the balcony open there was no great difference between outdoor and indoor allergenic activity, but with the balcony closed there was a reduction of indoor allergenic activity of about one-third in comparison with outdoor allergenic activity. Statistical analysis (Pearson correlation test) indicated a significant correlation between outdoor allergen levels and indoor allergen levels with the balcony open (r = .4415, P < .05), but not with the balcony closed (r = .3160, P > .05); a significant correlation between outdoor pollen count and indoor allergen levels with the balcony open (r = .4809, P < .05), but not with the balcony closed (r = .3858, P > .05); and a highly significant correlation (r = .5225, P < .001) between outdoor pollen count and outdoor allergen levels. CONCLUSIONS: These data provide scientific evidence for the recommendation to hay fever patients to remain indoors during seasons with high levels of outdoor pollens.

Air Pollutants↗
PubMed1996

Spinal clonidine produces less urinary retention than spinal morphine.

We have conducted a double-blind, randomized study in two groups of 20 patients each, undergoing hip surgery during spinal anaesthesia, to compare the incidence of urinary retention after spinal morphine or clonidine. Patients received 0.5% spinal bupivacaine 15 mg combined with either clonidine 75 micrograms or morphine 0.2 mg. After operation, patients were examined for micturition, bladder distension, or both; when they failed to void, they received naloxone 0.2 mg, and if bladder distension persisted, a catheter was inserted. At 12 h, all patients in the morphine group but only five in the clonidine group had bladder distension, and at 24 h this was present in seven and one patient in the morphine and clonidine groups, respectively (P < 0.001). Naloxone was given in 16 and one, and a catheter was placed in one and six patients in the morphine and clonidine groups, respectively (P < 0.001). We conclude that spinal clonidine impaired bladder function to a lesser extent than morphine.

Adult↗
PubMed1996

Monomeric chemically modified allergens: immunologic and physicochemical characterization.

Allergenic extracts (Der p, grass, and Parietaria) or single allergens such as Par j I (the major allergen of Parietaria) and ovalbumin (OA), a food allergen widely used in animal models, were chemically modified by reaction with potassium cyanate (KCNO), which transforms the epsilon-amino group of the lysine of proteinaceous allergens into ureido groups. KCNO-modified (carbamylated) allergens have low allergenic potency, as demonstrated in vitro (RAST inhibition) and in vivo (passive cutaneous anaphylaxis). When used to immunize rabbits, carbamylated allergens still induce IgG antibodies able to cross-react with native allergens (immunoblotting experiments). An interesting feature distinguishing carbamylated allergens from other chemically modified allergens is the preservation of the native monomeric dimension as demonstrated by SDS-PAGE analysis. Results are discussed from the perspective of clinical application of carbamylated allergens.

Allergens↗
PubMed1994

Modified par j I allergen from P judaica pollen and its rate of absorption in rats.

Polymerized allergens (allergoids) have been introduced in the immunotherapy of allergic disease in order to reduce the risk of side effects. However, their high molecular weight can be a limit, particularly when they are administered by a route involving passage through the mucosal barrier. We describe a simple procedure aimed at developing an original modified allergen with significantly less allergenic potential (intended as human IgE-binding capacity) but preserving the monomeric nature of the molecule. Par j I, the major allergen of Parietaria judaica pollen, was purified by a combination of monoclonal antibodies and affinity chromatography. Par j I allergen was then modified by reaction with potassium cyanate (KCNO), and compared with the native allergen to evaluate its allergenic potency (RAST-inhibition) and molecular weight (SDS-PAGE). Modified allergen showed significantly lower allergenic potency but kept its original molecular weight, making it particularly suitable for buccal (sublingual) administration. To study the adsorption profile, modified Par j I was radiolabeled and administered intravenously and sublingually to normal rats. The prospects for clinical application of the modified allergen are discussed.

Absorption↗