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Biomedical subjects

R Franchi

Publications and source records attributed to R Franchi.

At least 37 records · Page 2Linked to original sources
PubMed1991

Dipyridamole technetium-99m-2-methoxy isobutyl isonitrile tomoscintigraphic imaging for identifying diseased coronary vessels: comparison with thallium-201 stress-rest study.

A same-day double injection protocol employing 99mTc-methoxyisobutyl isonitrile (MIBI) and myocardial single-photon emission computed tomography (SPECT) for detecting coronary artery disease (CAD) was assessed in 30 patients. SPECT was performed 1 hr after a first injection (250 MBq) of 99mTc-MIBI, given after 0.56 mg/kg dipyridamole (DPD) infusion. Patients were then reinjected at rest (750 MBq) and were reimaged 1 hr later. Within 1 wk, all patients underwent a complete stress-rest SPECT thallium study. Of the 330 myocardial segments evaluated, 25 were judged ischemic by both techniques, while persistent defects were demonstrated in 50 and in 47 with 99mTc-MIBI and 201TI, respectively. Six regions were considered for diseased vessels identification. Sensitivity and specificity for CAD were 100% and 75%, respectively, for both 201TI and 99mTc-MIBI. Sensitivity for identification of diseased vessels by 201TI was 68% for LAD, 89% for RCA, and 80% for LCX as opposed to 75%, 89% and 80%, respectively, by 99mTc-MIBI. Specificity was 93% in both cases for LAD, 73% and 63% for RCA, and 53% and 46% for LCX.

Adult↗
PubMed1990

[Double injection of Tc99m-methoxy isobutyl isonitrile in the same session: diagnostic accuracy in tomography compared with that of thallium-201 chloride].

Radionuclide imaging with thallium-201 is widely accepted for identifying the presence and the severity of coronary artery disease, but this radiotracer is hampered by some limitations (low-energy photons and long physical half-life) and by delivering difficulties. Therefore, various technetium 99m-labelled compounds have been proposed as myocardial perfusion agents. In particular, technetium 99m methoxy isobutyl isonitrile (Tc99m-MIBI) showed the most favourable characteristics for clinical applications. Recently a study protocol involving a split dose of the radiocompound injected in the same day has been proposed. The aim of this work has been to evaluate the diagnostic accuracy of this procedure coupled with tomographic study (SPECT-MIBI) in a group of patients with documented coronary artery disease and to compare the results with those obtained by means of Tl-201 tomographic studies (SPECT-Tl) in the same patient group. Twenty-four patients, 21 males and 3 females, entered the study: the mean age was 57 +/- 6 years (44-71). For the rest study the patients were given 250 MBq of Tc99m-MIBI. Then, after 2-3 hours, they were reinjected with a second dose of 750 MBq when exercise endpoints were reached. The studies with Tl-201 were carried out the week before or subsequent the Tc99m-MIBI studies. Sensitivity was 88% with SPECT-Tl and 78% with SPECT-MIBI for the anterior descending artery (LAD), 86% and 64% respectively for right coronary artery disease (RCA) and 69% with both procedures for the left circumflex artery (LCX). Specificity was 88% with SPECT-Tl and 78% with SPECT-MIBI LAD, 60% with both procedures for RCA and 55% and 81% respectively for LCX. Coronary artery disease, involving 2 or more vessels, was correctly identified in 93% of patients by Tl-201 studies and only in 60% of patients by Tc99m-MIBI. In several cases the high count rate obtained by Tc99m-MIBI did not allow the identification of hypoperfused segments. In conclusion, a rest-stress double injection of Tc99m-MIBI in a same-day protocol has shown a lower sensitivity for detecting coronary lesions than Tl-201. Moreover, radiation exposure for medical and technical staff is greater with Tc99m-MIBI than with Tl-201.

Adult↗
PubMed1989

Clinical and hemodynamic effects of long-term administration of gallopamil in patients with coronary artery disease and normal or impaired left ventricular function.

The hemodynamic and clinical profiles of gallopamil, a new calcium antagonist, were evaluated in 20 patients with severe coronary artery disease in a placebo-controlled, single-blind study. The patients were divided into 2 groups depending on baseline ejection fraction (greater than 45 or less than or equal to 45%) and underwent nuclear ventriculography, both at rest and during bicycle exercise under electrocardiographic monitoring, after 3 weeks of therapy (50 mg 3 times daily) and the 1-week run in and washout placebo periods. The mean anginal weekly frequency per patient was significantly reduced, from 3.4 to 0.5 (p less than 0.001). The left ventricular ejection fraction, cardiac volumes, ejection and filling indexes at rest and for the same workload were not altered in the population as a whole or in each of the 2 groups. The rate pressure product during exercise was reduced for the same workload from 18.0 +/- 5.0 X 10(3) to 16.8 +/- 4.7 X 10(3), while the regional ejection fraction in ischemic regions was not significantly changed. Individual variations of ventriculographic parameters in both groups were not related to basal values. Gallopamil increased the total duration of exercise from 432 +/- 201 to 537 +/- 188 s (p less than 0.001). Six patients did not complain of angina and their exercise was interrupted because of muscular weakness. The hemodynamic and clinical responses did not differ when the results in the population as a whole and in each of the 2 groups were compared. Gallopamil was effective and well tolerated, even in patients with very depressed cardiac function.

Aged↗
PubMed1989

Evaluation of hypertensive patients by means of captopril enhanced renal scintigraphy with technetium-99m DTPA.

One-hundred five hypertensive patients underwent conventional renal scintigraphy followed 2 or 3 days later by Captopril-enhanced renal scintigraphy, performed 1 hr after premedication with 50 mg of Captopril per os. All patients were then submitted to renal arteriography, performed within 15-30 days. Fifty-five patients had no renal artery stenosis, 29 had unilateral disease, and 21 bilateral. Overall, 34/37 patients were diagnosed by the provocative test as having at least one renal artery affected by a stenosis greater than 50%. Of those with no stenosis (n = 55) or stenosis less than 50% (n = 13) only two cases were falsely positive. Thus sensitivity was 92% and specificity 97%. For single kidney identification with stenosis greater than 50%, sensitivity of renal scintigraphy after Captopril administration was 94% and specificity 98%. Captopril enhanced renal scintigraphy is thus suggested as the first test to be performed in hypertensive patients referred for renal scintigraphic studies. Only those cases with equivocal results require a baseline study for better assessment.

Adult↗
PubMed1980

Isotope phlebography in the study of lower extremity venous thrombosis.

Isotope phlebography is performed using 99mTc as pertecnetate, macroaggregates of albumin (MAA) or microspheres of albumin (MISA). The isotope is injected at a dose of 6-10 mCi into the dorsal foot veins. The area studied begins at the knee and is followed successively by the groin, the iliac area and the region of the IVC. A pulmonary scan is performed when MAA or MISA are used. Our method has proven to be reliable in showing 1) thrombosis of the veins of the groin and iliac area, which appear as a 'non visualisation' of the venous tract, 2) delayed transit time of the isotope, 3) visualisation of the superficial circulation (changes and irrgularities). The association of istope phlebography with pulmonary scan is useful for evaluating the femoral-iliac and the vena caval system and for detecting the presence of pulmonary embolism.

Acute Disease↗
PubMed1979

Parenteral administration of ketoprofen in osteoarthritis: a double-blind trial versus the N-methyl-d-glucamine salt of indomethacin.

In a double-blind trial 40 patients with ostheoarthritis were treated for relief of pain with ketoprofen or with the N-methyl-d-glucamine salt of indomethacin, both drugs being administered i.m. at the dosage of 100 mg/day for 12 days. Ketroprofen and the indomethacin salt significantly improved pain, functional capacity and walking distance, while only the former reduced the knee size in the patients with gonarthritis. The two drugs showed roughly the same latency period and the same duration of activity. Ketoprofen was perfectly tolerated: on the contrary, in one patient treated with the indomethacin salt, the treatment was stopped because of vascular hypotension and cutaneous rash. A significant increase of blood urea nitrogen was observed only in the group of patients treated with the indomethacin salt.

Clinical Trials as Topic↗
PubMed1976

[Controlled clinical trial of a new synthetic preparation (parsalmide) in the treatment of inflammatory and degenerative arthro-myopathies].

A double-blind, between-patients trial of a new drug (parsalmide) against indomethacin in the relief of inflammation and pain in 68 patients with exacerbated inflammatory and-or degenerative arthromyopathy resulted in 76% of successful results with both drugs. Tolerance was good, though side-effects, albeit slight, were more common with indomethacin.

Adult↗