PubMed Health⌕ Search

Biomedical subjects

R Greco

Publications and source records attributed to R Greco.

At least 91 records · Page 5Linked to original sources
PubMed1990

Long-term efficacy of nitroglycerin patch in stable angina pectoris.

Subchronic and chronic efficacy of a 10 mg of nitroglycerin (NTG) patch was studied in 30 patients with stable angina pectoris. The trial consisted of 2 periods of study: 1 period of 2 months with a double-blind, crossover, placebo-controlled design and a second period of open treatment with verum patch. Two 7-day washout periods were performed at entry and at the end of the study. Efficacy was evaluated by clinical assessment of anginal attacks and NTG consumption and by means of multistage treadmill exercise testing. Exercise tests were performed at time 0 (24 hours from application of last patch), at 4 and 12 hours after dosing at the end of first 7-day washout, at the end of the first month of treatment, at the end of the second month of treatment after crossover, at the end of 3 months of treatment with active patch and at the end of the second 7-day washout period. Statistics were obtained by multivariate analysis of difference. In 27 patients whose records were available for final analysis the daily attacks of angina and NTG consumption decreased significantly during both the subchronic and chronic phases of the trial compared with placebo (p less than 0.001). Subchronic study showed significant improvement of maximal exercise duration, time to onset of angina, time to ST-segment depression of 1.0 mm, time to regression of angina and time to regression of ST depression, compared with placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Cutaneous↗
PubMed1990

Approach for oxygenation of the newborn with airway obstruction due to a cervical mass.

Large congenital cervical neck masses present major difficulties in management of the neonatal airway at delivery and in the perinatal period. With ultrasound, these lesions can be predicted prenatally. An airway treatment plan can then be formulated and modified in relation to the airway presentation at birth. We describe a case of a massive cervical-mediastinal teratoma and our management plan. Preparation involved a multidisciplinary approach including endoscopy to secure the airway while the neonate remained on fetal circulation and an extracorporeal membrane oxygenation system was available. Once the infant's condition was stable, a cervical approach with resection of the massive teratoma with mediastinal dissection without sternotomy was successful. A differential diagnosis of cervical neck masses and review of cervical teratomas is presented.

Adult↗
PubMed1989

Intravenous amiodarone in acute anterior myocardial infarction: a controlled study.

A randomized, single-blind controlled study intended to assess the potential benefits of intravenous amiodarone in anterior myocardial infarction is presented. Three hundred nineteen patients entered the study, 159 received amiodarone infusion, and 160 received glucose-insulin-potassium (GIK) infusion. Basal characteristics were similar in the two experimental groups, who were randomized on a consecutive basis. Exclusion criteria were shock or pulmonary edema, hypotension, inferoposterior infarction, bradycardia, antrioventricular block, severe diabetes, and other major diseases. Patients aged 27 to 70 years, with a Q-wave anterior infarction, initiated 12-40 hours earlier at the time of admission, entered the trial. Other entry criteria were heart rate higher than 80 beats/min and systolic blood pressure higher than 100 mmHg. Amiodarone was administered in saline infusion 10-20 mg/kg, within 4 to 10 hours, through a central vein. GIK infusion consisted of 150-300 g of glucose, 25-50 IU of insulin, and 80-120 mEq of KCl in 1000 cc of water at a rate of 1.5-2.0 ml/g/hour. Both groups received digitalis, nitrates, sedatives, and diuretics as needed. Although individually the major endpoints of death, reinfarction, and sustained supraventricular and ventricular arrhythmias did not differ significantly, each was less in the amiodarone group than in the control, and the sum of all adverse events was significantly lower for the amiodarone patients (p less than 001). Heart failure and conduction disturbances were not different in the two groups. This study shows that amiodarone, with its vasodilating and antiarrhythmic properties, may be beneficial in acute anterior infarction, but further studies on larger populations will be necessary in order to show a reduction of mortality rate.

Acute Disease↗
PubMed1988

Electrophysiologic effects and clinical efficacy of flecainide in children with recurrent paroxysmal supraventricular tachycardia.

The electrophysiologic effects of intravenous flecainide were evaluated in 16 patients aged 9 +/- 4 years: 15 with recurrent paroxysmal supraventricular tachycardia (SVT) and 1 with overt accessory pathway and history of syncope. Eleven patients had an accessory pathway; it was concealed in 2, overt in 9 and in 10 of these patients an orthodromic atrioventricular reentrant tachycardia was induced. Five patients without accessory pathway had an atrioventricular nodal reentrant tachycardia. After intravenous flecainide (1.5 mg/kg) the effective refractory period of the atrium and ventricle increased significantly; the anterograde and retrograde effective refractory periods of the atrioventricular node did not. Flecainide blocked retrograde conduction in the accessory pathway in 4 patients (effective refractory period 245 +/- 41 ms) and anterograde conduction in 8 of 9 patients (effective refractory period 284 +/- 57 ms). The mean cycle length of orthodromic reciprocating tachycardia and atrioventricular nodal reentrant tachycardia increased significantly. After flecainide tachycardia was noninducible in 6 patients with orthodromic reciprocating tachycardia and in 1 with atrioventricular nodal reentrant tachycardia. It was inducible but nonsustained (less than or equal to 30 seconds) in 1 patient with orthodromic reciprocating tachycardia and in 3 with atrioventricular nodal reentrant tachycardia. Fifteen patients continued oral flecainide treatment for 19 +/- 11 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1988

Efficacy of a new transdermal nitroglycerin patch (Deponit 10) for stable angina pectoris.

In this double-blind randomized placebo-controlled crossover study, the antianginal and anti-ischemic effect of a new transdermal system, releasing 10 mg of nitroglycerin (NTG) over 24 hours, was assessed in 19 outpatients with stable exercise-induced angina pectoris. The trial consisted of a 3-day washout: a 1-week period with verum or placebo patch followed by a second 1-week period with the other patch. During the study only sublingual NTG was allowed, and its consumption and the number of attacks recorded. Treadmill exercise tests were performed at the end of washout before patch application (baseline test) and 3 and 24 hours, respectively, after each period of 7 days of application of 1 patch daily. Systolic blood pressure and heart rate did not vary significantly at rest in the 17 patients who completed the trial. Angina was reduced 31.3% and NTG consumption 34.3% (p less than 0.01) during the week with Deponit 10 as compared with placebo. Exercise duration increased 29 and 16.1% (p less than 0.001 and p less than 0.1, respectively) at 3 and 24 hours with a verum patch as compared with placebo. ST-segment depression at comparable loads decreased 69 and 40.5% (p less than 0.01) at 3 and 24 hours, respectively, after application of Deponit. Onset of angina was delayed and maximal heart rate-blood pressure product significantly increased at 3 and 24 hours of treatment. It is concluded that Deponit 10 patch is effective in reducing anginal attacks and in increasing exercise capacity up to 24 hours after application.

Administration, Cutaneous↗
PubMed1987

Protective action of acetylcarnitine on NADPH-induced lipid peroxidation of cardiac microsomes.

Rat cardiac microsomes treated with NADPH generated a chemiluminescence, detected by the chemilumigenic probe lucigenin. The chemiluminescent signal, which is an index of lipid peroxidation, was found to be inhibited by acetylcarnitine in a dose-dependent way. Superoxide dismutase (SOD) and inhibitors of arachidonate metabolism were also effective in preventing light emission. The combined action of acetylcarnitine plus SOD and acetylcarnitine plus indomethacin suggested a possible common target for the compounds. When tested on superoxide production from isolated human neutrophils detected both by luminol-amplified chemiluminescence and cytochrome C reduction, acetylcarnitine did not show any inhibitory effect. The results of these experiments demonstrate the antioxidant properties of acetylcarnitine, even if they cannot clarify the specific target of the drug action.

Acetylcarnitine↗
PubMed1987

[2-dimensional echocardiography in infarct of the right ventricle: correlation with clinical, hemodynamic and scintigraphic findings].

Right ventricular wall motion was studied in 18 patients hospitalized for acute myocardial infarction by means of cross-sectional echocardiography. Diagnosis of right ventricle myocardial infarction was made on the basis of clinical, electrocardiographic, hemodynamic criteria, respectively present in 66%, 80% and 66% of our patients. Echocardiographic criteria of right ventricle infarction were: 1) right ventricle dilatation; 2) segmental or global right ventricle wall motion abnormalities; 3) paradoxical motion of interventricular septum; 4) tricuspid insufficiency; 5) inferior cava vein dilatation with paradoxical respiratory pattern. Seven patients were studied by means of radionuclide techniques, that confirmed right ventricle infarction in 6 patients. We conclude that: 1) the most accurate echocardiographic views for right ventricle wall motion study are subcostal views and, in particular, the subcostal short-axis (OAS 60 degrees); 2) those patients (12/18) with a specific echocardiographic pattern for right ventricle infarction presented a specific clinical and hemodynamic picture; 3) those patients (6/18) with only segmental right ventricular wall motion abnormalities presented an aspecific clinical and hemodynamic picture. Moreover we showed that an improvement of right ventricular wall motion was observed in some cases within a few days of the infarction. Further observations are needed to assess the frequency and late prognosis of acute right ventricle infarction.

Adult↗
PubMed1985

10-year follow-up of patients with intraventricular conduction defects associated with myocardial infarction: the meaning of QRS duration.

The 10-year survival rate of 66 patients discharged after an acute myocardial infarction associated with intraventricular conduction delay is reported. The whole population under study consisted of 321 patients followed for 10 years or until death. In 46 patients (69.7%) the conduction delay was a definite complication of infarction, in 15 (22.7%) it preceded the acute event and in 5 (7.5%) the time of onset was undetermined. Mortality in the presence of a conduction delay was 74.2% in 10 years vs 39.2% in its absence (p less than .001). Death was sudden in 41.6% of fatalities when a conduction defect was present and 28% in its absence (p less than .01). The 10-year survival was 55% in patients with conduction defects and QRS less than .12 sec duration, 23.8% if QRS was between .12 and .14 sec, and 4% when QRS duration was greater than .14 sec. 72% of patients of this latter group was in NYHA class 3 or 4, whereas 70% of patients with QRS less than .12 sec and 47% of patients with QRS .12 to .14 sec were in class 1 or 2. These data show that long-term prognosis of conduction delay associated to myocardial infarction is poor and stratification of risk of death is possible among these patients on the basis of QRS duration.

Death, Sudden↗
PubMed1985

[Long-term (10 years) predictive value of the exercise test after myocardial infarct and significance of the longitudinal repetition of the test during follow-up].

Our follow-up after myocardial infarction consists of 321 patients followed for 10 years or until death. 147 patients, free of clinical features associated with high risk of subsequent events, underwent a late exercise test at cycloergometer 6 to 17 months after infarction. Ten year mortality was 48.3% and 10.3% in patients with a positive or a negative test respectively (p less than 0.0001). Incidence of nonfatal reinfarction was 4.6% and 33.3% respectively (p less than 0.001). 108 patients underwent a second test later in the follow-up (2.8 +/- .9 years): in 27 patients who were positive at first test the second test was also positive and mortality was 33.3%. Sixteen out of 81 patients with a former negative test resulted positive at a repeat test and mortality was 37.5% vs a 3% mortality rate among 65 patients who were negative at both tests. Thus long-term prognostic significance of exercise stress testing after acute myocardial infarction is confirmed and extended, despite limitation of a late test. Moreover, the second test along the follow-up allows further stratification. In conclusion, patients with a negative test and without clinical features predictive of poor prognosis constitute a very low risk group who need not undergo invasive testing, whereas patients with a positive result or who become positive at following test deserve further evaluation and may become bypass candidates in the ensuing years.

Evaluation Studies as Topic↗
PubMed1984

Esters and N-substituted urethanes of 6-cis-dimethylamino-1,3,3-trimethyl-2-oxabicyclo[2.2.2]octan-5-cis-ol with hypotensive and other activities.

The synthesis of 6-cis-dimethylamino-1,3,3-trimethyl-2-oxabicyclo [2.2.2] octan-5-cis-ol (III) starting from 6-cis-dimethylamino-1,3,3-trimethyl-2-oxabicyclo [2.2.2] octan-5-trans-ol (I) is described. Starting from aminoalcohol (II), a series of esters (IV) and N-substituted urethanes (V) was prepared. Benzoate (IV e) showed a remarkable hypotensive and bradycardic activity in rats, whereas acetate (IV a) showed infiltration anesthesia and antiarrhythmic activity in mice slightly inferior to those of lidocaine. Antiacetylcholine activity in vitro is also reported.

Acetylcholine↗
PubMed1984

Inhibiting effect of levamisole on superoxide production from rat mast cells.

The aim of the present study was to test whether levamisole acts as a superoxide scavenger. The drug was incubated at four different concentrations (range 1, 5, 10, 20 micrograms/ml) with purified rat mast cells which were then induced to generate superoxide ions, by challenge with compound 48/80 (1 microgram/ml). Ten minutes preincubation with the drug completely abolished superoxide ions production. Addition of levamisole to the cell suspension simultaneously with the releaser caused full inhibition of O2(-) generation at the lowest dose, while higher doses failed to suppress 48/80 induced O2(-) generation. In a cell-free superoxide-generating system, like xanthine-xanthine oxidase, levamisole did not act as a superoxide scavenger at any of the doses tested.

Animals↗