PubMed Health⌕ Search

Biomedical subjects

O Mantero

Publications and source records attributed to O Mantero.

At least 19 recordsLinked to original sources

Comparison of three different methods of monitoring unwanted effects during antihypertensive therapy.

In a double-blind, randomized, crossover, multicenter study performed in 227 hypertensive outpatients, two antihypertensive drugs, oxprenolol and chlorthalidone, were investigated to determine unwanted effects. Three main methodologic procedures were applied: the conventional evaluation of unwanted effects by the physician and involving the whole patient population, the checklist, and the free questionnaire. The latter two were assigned by randomization to the patients themselves. The study showed that unwanted effects seem to be frequently overreported when a checklist is used, whereas the free questionnaire gives more information about the symptoms of the disease than about the tolerance of the drug. The conventional method, when physicians are well-informed and sensitized to the problem, seems to provide more reliable information about unwanted effects of a drug.

Adolescent↗

Effects of moderate salt restriction in hypertensive patients treated with oxprenolol or chlorthalidone.

Ninety-five hypertensive out-patients, whose lying diastolic blood pressure was still greater than or equal to 95 mm Hg after a 4-week treatment with oxprenolol slow release 160 mg/day or chlorthalidone 25 mg/day, restricted their daily sodium intake for a 4-week period, while continuing to receive the previous pharmacological therapy. The dietary intervention, appositely formulated to moderately restrict sodium intake, resulted in a high patient compliance as assessed by the significant (p less than 0.01) reduction in the 24-hour urinary sodium excretion. At the end of the 4-week dietary period, a significant (p less than 0.01) decrease in lying and standing systolic and diastolic blood pressure was observed in both the oxprenolol and chlorthalidone treated groups. These results suggest that a moderate reduction in sodium intake, obtained from a low sodium diet characterized by high patient compliance and easily followed in everyday life, is effective in lowering blood pressure in hypertensive patients who don't respond satisfactorily to pharmacological therapy alone.

Adult↗

Pharmacological control of platelet-vessel wall interactions in patients with chronic obstructive airway disease.

In the last few years great interest has been devoted to the role of platelet activation in the haemodynamic and thrombotic complications which frequently occur in patients with chronic obstructive airway disease. Several recent studies have shown, in fact, a number of alterations of platelet function in this pathological condition, such as an increased betathromboglobulin level and higher levels of malondialdehyde after collagen and thrombin platelet stimulation compared to age and sex matched control subjects. Our study indicates that the platelet regeneration time is shortened in patients with chronic obstructive airway disease in respect to that of controls (p less than 0.001). The administration of dipyridamole (425 mg/die) resulted in a significant prolongation of the platelet regeneration time in these patients indicating that the drug was effective in reducing the increased platelet turnover.

Aspirin↗

Dipyridamole treatment in chronic obstructive airways disease: effect on platelet regeneration time.

The platelet regeneration time (PRT) determined in a group of hypoxaemic patients with chronic obstructive airways disease (COAD), before and after treatment with dipyridamole 150 mg tid, was compared with a group of control subjects. The PRT was computed by a modified non-radioisotope technique and was expressed as t1/2 in days. The patient group showed a significantly shortened PRT as compared to controls of the same age and sex (2.10 +/- 0.16 vs 3.65 +/- 0.26 days; p less than 0.001). One month of dipyridamole administration resulted in prolongation of the PRT in COAD patients (2.10 +/- 0.16 days pre-treatment vs 2.75 +/- 0.20 post-treatment; p less than 0.01), without affecting the platelet cyclo-oxygenase system. This study indicates that dipyridamole may be beneficial in pathological conditions, which are characterized by increased platelet turnover, possibly leading to frequent thromboembolic complications.

Adult↗

Fecal cholesterol excretion studies in type II hypercholesterolemic patients treated with the soybean protein diet.

The fecal steroid elimination profile was studied in 7 type II hyperlipoproteinemic patients given a low-lipid diet with textured soybean proteins, in order to define the mechanism of the hypocholesterolemic activity of this new dietary regimen. Four of the patients followed a 3- + 3-week cross-over protocol, comparing the soybean diet with a reference low-lipid diet with animal proteins. In these, fecal neutral steroids and bile acids were analyzed by chromatography during the two dietary periods. In spite of the clear hypocholesterolemic effect, no significant differences in steroid output were noted between the two dietary periods. In the 3 remaining patients, a chromatographic + isotopic method (by injecting 14C-labelled cholesterol i.v. 4-6 weeks prior to the dietary study) was employed. Again, no marked changes were noted in the fecal neutral steroid and bile acid outputs and the slope of the decay curve of the plasma cholesterol-specific activity was not changed by the experimental diet, in spite of the remarkable decrease in plasma cholesterol. The reported results do not provide a definitive contribution to the mode of action of the soybean protein diet. They suggest, however, that it is not an effect mediated by undigestible dietary components. The possibility of a cholesterol redistribution from plasma to tissue pools should be considered.

Bile Acids and Salts↗

Plasma lipid and lipoprotein changes in hypertensive patients treated with propranolol and prazosin.

The effects of propranolol and prazosin on plasma lipoproteins in patients with essential hypertension were evaluated according to a crossover protocol of two 8-week periods with a washout of 4 to 6 weeks. Eleven patients with moderate hypertension (greater than 90 but less than or equal to 144 mm Hg, diastolic) and slightly overweight (+10% to +/- +30%, according to Metropolitan Life Insurance tables) were selected. No dietary changes were prescribed. Plasma cholesterol, triglycerides (TG), and lipoprotein changes were monitored at the beginning of each sequence and at 2-, 4- and 8-week intervals. Prazosin, when given first, did not essentially modify any of the metabolic parameters, except for a slight elevation in plasma apoprotein AI levels, i.e., the main protein component of high density lipoprotein (HDL); propranolol caused a significant rise in total TG and very low density lipoprotein TG (VLDL-TG) levels (+37.3% and +23.9%, respectively). Somewhat lower total TG (+19.6%) and vLDL (17.8%) TG elevations were noted when propranolol was given first; plasma glucose was also significantly raised (+12.8%). Triglyceride and glucose levels returned to normal upon changing to prazosin. Total plasma- and lipoprotein-associated cholesterol levels were essentially unchanged with either drug; similarly, no significant changes were detected in total plasma apoprotein B (the main protein component of LDL and also VLDL), a component of apoprotein AI levels. Uric acid levels were slightly raised on propranolol. There was an 8.8% reduction in uric acid levels when the medication changed from propranolol to prazosin.

Apoproteins↗

Relationship between chronic PaCO2 and total body buffering capacity in patients with chronic obstructive lung disease.

17 subjects were carefully selected among 150 patients with COLD: all patients with one or more conditions or diseases that could alter the physiological response to chronic hypercapnia were eliminated. During a period of 13 to 28 days, the acid-base response to slow carbon dioxide changes was studied in the selected patients. Total body buffering capacity was expressed as dH+a/dPaCO2 and showed to be an inverse function of chronic PaCO2 (defined as the value of PaCO2 in clinical and acid-base steady status for each patient), according to the previous suggestions of Weiss and Dulfano and to the report of Ingram and co-workers during acute carbon dioxide changes in the same patients.

Acid-Base Equilibrium↗

[The pulmonary artery hypertension in patients with sarcoidosis (author's transl)].

Svanborg (1961) found normal pulmonary artery mean pressures in eleven patients with stage II sarcoidosis. By contrast Gluskowski et al. (1978) have shown few abnormally high values in the same condition. We have not found published haemodynamic data concerning stage O sarcoidosis. Thus we have performed right haemodynamic study (by Swan-Ganz catheters) on 19 patients with hystologically proven sarcoidosis (8 stage III, 6 stage II, 3 stage I and 2 stage 0). 13 of them underwent also haemodynamic study during exercise (1watt/Kg). Pulmonary artery hypertension (at rest or after exercise) was frequently found in stage III, and less frequently in stage II. In stage I pulmonary artery mean pressure was between 15 and 20 mmHg in three patients (out of three). In one case (out of two) in stage 0 (admitted to hospital owing to exertional dyspnoea) right heart catheterisation showed pulmonary hypertension during exercise in spite of normal pulmonary function tests (including spirometry, DLCO, pulmonary scintigrafic and X-ray pattern also using 3X magnification radiology).

Adult↗

Clinical experience with the soybean protein diet in the treatment of hypercholesterolemia.

The efficacy of the total substitution of animal proteins with a textured soybean protein in hypercholesterolemic individuals was assayed in 42 in-patients and 18 out-patients. The in-patients studied followed one of three different crossover protocols: in protocol A, the soybean diet was compared with a standard low lipid diet; protocol B compared two soybean diets, one with added cholesterol, one without; and protocol C compared a soybean diet containing a high P/S fatty acid ratio to one with a low P/S ratio. In all three protocols, the soybean regimen provided valid and reproducible hypocholesterolemic effects that were not modified by the addition of cholesterol. P/S variations appeared, however, to modify the final effect: soybean definitely had a decreased effectiveness with a low P/S (0.1) regimen. The overall plasma cholesterol changes in the 42 in-patients after 3 weeks on the different soybean diet protocols was -20%. Patients with type IIA and IIB hypercholesterolemia provided almost equivalent results, whereas patients with mixed phenotypes (IIB-III) appeared somewhat more sensitive to the dietary effect. Cholesterol decreased mostly in the low density lipoprotein fraction, but some very low density lipoprotein changes were also noted upon variation of the P/S ratio. The out-patients studied provided less satisfactory results. possibly due to the difficulty of adequately complying with the diet. These studies indicate that treatment with the soybean diet is an effective regimen for inducing a significant cholesterol reduction in type II patients refractory to standard low lipid regimens.

Adult↗

Preliminiary data on the pharmacokinetics of glaziovine in man.

The pharmacokinetic parameters of Glaziovine, a pro-aporphine alkaloid with neuropharmacological properties, were investigated in healthy human volunteers. Glaziovine-14C 20 mg was administered in capsules (oral route) and in vials (i.v. route). Total radioactivity was meausred in plasma, urine and faeces. When administered orally, peak plasma levels were encountered at 2 h. The cumulative urinary excretion of total radioactivity over a 24 h period was 38% after oral and 50% after i.v. administration. Investigation of metabolites in urine revealed Glaziovine glucuronide as the sole metabolite of the drug. By comparing the percentage of urinary excretion or the area under the plasma level-time curve (AUC) obtained in the first 24 hours after i.v. and oral administration, enteral absorption was found to range from 78 to 84%. Thus, glaziovine appears to show very high enteratral absorption.

Aporphines↗

Soybean-protein diet in the treatment of type-II hyperlipoproteinaemia.

A soybean textured protein induced a 14% decrease of plasma-cholesterol levels after two weeks and 21% after three when substituted for animal proteins in a group of 20 patients with type-II hyperlipoproteinaemia. Comparison of soybean diet with a standard low-lipid diet in the same patients, according to a cross-over protocol, indicated that this hypocholesterolaemic effect was not due to differences in the lipid composition of the two diets. The hypothesis that a soy protein has a hypocholesterolaemic action per se is supported by the results of a subsequent experiment in 8 type-II patients in whom the addition of cholesterol (500 mg/day) to soy protein did not modify the hypocholesterolaemic response.

Adult↗

Bioavailability of digoxin in a new soluble pharmaceutical formulation in capsules.

The in vitro dissolution and the bioavailability of two pharmaceutical formulations of digoxin were compared, one being a common commercial tablet form and the other a solution of the glycoside in soft gelatin capsules. Digoxin capsules dissolved more readily in vitro and showed higher bioavailability than digoxin tablets in both dogs and humans. In dogs, the capsules and tablets were compared with an elixir of digoxin, which possesses complete bioavailability. The better bioavailability of digoxin capsules as compared with tablets may be explained by the fact that this formulation contains the cardiac glycoside in a solution.

Adult↗

Regional lung perfusion and pulmonary artery pressure in chronic obstructive lung disease.

In 22 chronic bronchitics with or without emphysema, the authors measured regional pulmonary perfusion in the supine position and calculated the ratios of radio-active tracer (131I-MAA) concentrations in the lung apices and bases (U/L ratio). This ratio was found to be normal in the right lung and tendentially high (though not to a statistically significant degree) in the left lung, this being probably due to the presence of an enlarged heart (13 patients showed evidence of right ventricle hypertrophy and/or overload). The correlation between the U/L ratio and functional impairment of respiration expressed spirometrically failed to reach statistical significance and the same was true of the correlation between the U/L ratio and mean pulmonary arterial pressure at rest.

Adult↗