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Biomedical subjects

S Falchi

Publications and source records attributed to S Falchi.

29 records · Page 2Linked to original sources

The importance of presynaptic beta receptors in Raynaud's disease.

The purpose of the present study was to investigate the effect of atenolol, a beta 1-selective blocker, along with flunarizine, a calcium antagonist, in the management of Raynaud's disease. Forty patients with Raynaud's disease were randomized into a trial in which atenolol (50 mg daily) was given with flunarizine (10 mg daily). During the trial all patients were subjected to finger photoplethysmography and were given a diary to note daily the number and duration of the crises and presence or absence of pain and paresthesia. The association of atenolol with flunarizine caused an 80% reduction in the number of vasospastic crises, a significant increase (p less than 0.001) in the photoplethysmographic wave amplitude, and complete disappearance of pain and paresthesia. These results were not observed in patients treated with a placebo. Flunarizine reinforces the action of atenolol in causing a decrease in vasoconstriction in patients with Raynaud's disease, as observed previously by us, in that it acts directly on the beta-presynaptic receptors or on the calcium slow channels connected to the beta-receptors. The present study confirms that the principal role in the physiopathologic progression of Raynaud's disease seems to be played by a modification of the beta-presynaptic receptors in the nerve endings of the peripheral vessels.

Adolescent↗

The role of presynaptic beta-receptors in Raynaud's disease.

This report concerns the results of a study carried out to show the presence of presynaptic Beta adrenergic receptor supersensitivity in RD patients and the possibility to prevent or at least decrease this supersensitivity with Beta-blocker treatment. It is shown that the paradoxical vasoconstriction response to ISP infusion can be prevented in RD patients by the acute administration of Beta-blocker, such as Atenolol or DL Propranolol. Moreover, chronic treatment with the correct Beta-blocker was seen to prevent angiospastic crisis in these patients.

Adult↗

Chronobiological study on serum innumoreactive gastrin RIA levels in patients with liver cirrhosis.

After days of standardized conditions of life and standardized diets, serum gastrin levels were measured in 6 patients with liver cirrhosis on 3 consecutive days and in 14 normal controls on 1 day. Blood samples were drawn every 4 h. In patients as well as in controls, a significant serum gastrin circadian rhythm was noted. The daily mean serum gastrin levels of patients were not significantly different from those of controls. These results suggest a secondary role of the liver in gastrin metabolism.

Aged↗

[Intraoperative changes in aerobic and anaerobic metabolism as prognostic index in interventions of massive hepatic resection].

This study was conducted on 10 patients with primitive or metastatic liver tumors, scheduled for massive liver resections, in order to search for evidence of the existence of intraoperative prognostic indexes having a bearing upon postoperative survival. The following parameters were measured in every patient: HR, MAP, CVP, MPAP, WP, SVR, PVR, CI, DO2, VO2, BE, before the anhepatic period (A), during anhepatic period (B), 30' (C), and 60' (D) after liver reperfusion, holding constant Hct, body temperature, ETCO2, FiO2, anesthetic depth, and the degree of muscular relaxation. The patients were later divided into two groups: 1, nonsurvivors in the postoperative period (4 patients) due to MOF; 2, survivors (6 patients). The values of the measured parameters of the two groups were statistically evaluated at each of the above intervals, and within each group with respect to time A, taken as a control. No significant variations were found in HR, MAP, CVP, MPAP, WP, SVR, PVR, CI, and DO2. The VO2 diminished in both groups during the anhepatic period (B) (p less than 0.0025). In group 1 (nonsurvivors) the VO2 diminished after the reperfusion (p less than 0.0025), while in group 2 (survivors) VO2 rapidly resumed its initial values (n.s. 30' and 60' after the reperfusion). In the nonsurviving patients metabolic acidosis developed, with significant reductions of BE (p less than 0.0025) during times C and D, occurring simultaneously with the reduction of VO2.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Gelatin for volume replacement in hemodilution: hemodynamic study].

OBJECTIVE: To evaluate whether volume replacement with gelatine infusion with 3.5% urea bridges during normovolemic intentional hemodilution manages to stabilize hemodynamic parameters. EXPERIMENTAL DESIGN: Randomized prospective study. SETTING: Operating theatre for general surgery. PATIENTS: ASA 1 and 2 patients undergoing major abdominal surgery. Criteria of admission: a) age < 70 years old; b) starting hematocrit > 30%; c) absence of coronary diseases or coagulative pathologies. INTERVENTIONS: Blood lost during surgery was replaced with gelatine and crystalloid in a ratio of 1:1. Hemodynamic monitoring was performed by inserting an Opticath catheter in the pulmonary artery and the resulting data were processed using an Oximetrix computer. FINDINGS: Oxygen transport (DO2), oxygen consumption (VO2) and heart rate (HR) were measured before the start of the operation and at the peak of hemodilution. RESULTS: At times T0 = Hct 35 and T1 = Hct 28, studied parameters (DO2, VO2, HR) did not show statistically significant variations. CONCLUSIONS: On the basis of the hemodynamic parameters studied gelatine was found to be an efficacious volume replacement solution during the course of moderate, intentional hemodilution.

Excipients↗

[Anesthesia with sevoflurane vs propofol in elective extracavity surgery].

OBJECTIVE: To compare the cardiovascular effects and recovery characteristics of sevoflurane and propofol anesthesia in 80 ASA I and II patients undergoing elective extracavity surgery expected to last at least one hour. DESIGN: A prospective randomized clinical trial. METHODS: After meperidine and atropine premedication, the patients were randomly allocated into two groups: in the sevoflurane group thiopentone was administered for induction of anesthesia and sevoflurane for maintenance; the propofol group received propofol either for induction of anesthesia or maintenance. All patients received N2O, vecuronium, artificial ventilation and fentanyl as needed. Vital parameters were monitored during anesthesia and two hours later. Recovery times were recorded after anesthesia. Statistical analysis was performed with SAS (Statistical Analysis System). RESULTS: In the sevoflurane group, heart rate and diastolic pressure were slightly higher than in the propofol group. Recovery time was faster after sevoflurane anesthesia.

Adolescent↗