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Carnicelli G, Disconzi L, Cerasuolo M, Casiraghi E, Costa G, De Virgilio A, Esposito AA, Ferreli F, Fici F, Lo Casto A, Marra S, Malvezzi L, Mercante G, Spriano G, Torzilli G, Francone M, Balzarini L, Giannitto C. Image-Guided Intraoperative Assessment of Surgical Margins in Oral Cavity Squamous Cell Cancer: A Diagnostic Test Accuracy Review. Diagnostics (Basel) 2023; 13:diagnostics13111846. [PMID: 37296701 DOI: 10.3390/diagnostics13111846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/12/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023] Open
Abstract
(1) Background: The assessment of resection margins during surgery of oral cavity squamous cell cancer (OCSCC) dramatically impacts the prognosis of the patient as well as the need for adjuvant treatment in the future. Currently there is an unmet need to improve OCSCC surgical margins which appear to be involved in around 45% cases. Intraoperative imaging techniques, magnetic resonance imaging (MRI) and intraoral ultrasound (ioUS), have emerged as promising tools in guiding surgical resection, although the number of studies available on this subject is still low. The aim of this diagnostic test accuracy (DTA) review is to investigate the accuracy of intraoperative imaging in the assessment of OCSCC margins. (2) Methods: By using the Cochrane-supported platform Review Manager version 5.4, a systematic search was performed on the online databases MEDLINE-EMBASE-CENTRAL using the keywords "oral cavity cancer, squamous cell carcinoma, tongue cancer, surgical margins, magnetic resonance imaging, intraoperative, intra-oral ultrasound". (3) Results: Ten papers were identified for full-text analysis. The negative predictive value (cutoff < 5 mm) for ioUS ranged from 0.55 to 0.91, that of MRI ranged from 0.5 to 0.91; accuracy analysis performed on four selected studies showed a sensitivity ranging from 0.07 to 0.75 and specificity ranging from 0.81 to 1. Image guidance allowed for a mean improvement in free margin resection of 35%. (4) Conclusions: IoUS shows comparable accuracy to that of ex vivo MRI for the assessment of close and involved surgical margins, and should be preferred as the more affordable and reproducible technique. Both techniques showed higher diagnostic yield if applied to early OCSCC (T1-T2 stages), and when histology is favorable.
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Affiliation(s)
- Giorgia Carnicelli
- Department of Diagnostic and Interventional Radiology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
| | - Luca Disconzi
- Department of Diagnostic and Interventional Radiology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Michele Cerasuolo
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Elena Casiraghi
- AnacletoLab, Department of Computer Science "Giovanni degli Antoni", Università degli Studi di Milano, Via Celoria 18, 20133 Milan, Italy
- Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, 717 Potter Street, Berkeley, CA 94710, USA
| | - Guido Costa
- Division of Hepatobiliary and General Surgery, Department of Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | | | - Fabio Ferreli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Federica Fici
- Department of Diagnostic and Interventional Radiology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
| | - Antonio Lo Casto
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University Hospital of Palermo, 90127 Palermo, Italy
| | - Silvia Marra
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
| | - Luca Malvezzi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Guido Torzilli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
| | - Marco Francone
- Department of Diagnostic and Interventional Radiology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
| | - Luca Balzarini
- Department of Diagnostic and Interventional Radiology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
| | - Caterina Giannitto
- Department of Diagnostic and Interventional Radiology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
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Fici F, Seravalle G, Koylan N, Nalbantgil I, Cagla N, Korkut Y, Quarti-Trevano F, Makel W, Grassi G. Follow-up of Antihypertensive Therapy Improves Blood Pressure Control: Results of HYT (HYperTension survey) Follow-up. High Blood Press Cardiovasc Prev 2017; 24:289-296. [PMID: 28497339 DOI: 10.1007/s40292-017-0208-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 05/02/2017] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Although improved during the past few years, blood pressure control remains sub optimal. AIM The impact of follow-up assessment on blood pressure control was evaluated in a group of patients of the HYT (HYperTension survey), treated with a combination of different dihydropyridine calcium-channel blockers (CCBs regimen) and inhibitors of renin-angiotensin-aldosterone system (RAAS) and with uncontrolled blood pressure. This was obtained assessing (a) the rate of blood pressure control at 3 and 6 months of follow-up in the whole group of patients, (b) the rate of blood pressure control and the average blood pressure values in subjects treated with different DHP-CCBs regimen. METHODS From the 4993 patients with uncontrolled blood pressure, (BP ≥ 140/90 or ≥140/85 in patients with diabetes), 3729 (mean age 61.2 ± 11.5 years), maintained CCBs regimen combined wih RAAS blockers and were evaluated at 3 and 6 months follow-up. At each visit BP (semiautomatic device, Omron-M6, 3 measurements), heart rate, adverse events and treatment persistence were collected. RESULTS At 1st and 2nd follow-up the rate of controlled BP was 63.5 and 72.8% respectively (p < 0.05 vs 35.3% at baseline), whereas in diabetes was 32.5 and 37.9% respectively (p < 0.05 vs 20% at baseline). No differences in heart rate were observed. No differences in control rate were observed between the different CCBs regimen. The incidence of drugs related adverse events was 3.6%. CONCLUSIONS These findings provide evidence that: (a) the follow-up of hypertensive patients under therapy increase the rate of blood pressure control; (b) there is no significant difference in the antihypertensive effect between different CCBs regimen;
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Affiliation(s)
- F Fici
- Clinica Medica, Università Milano Bicocca, via Pergolesi 33, Monza-Milan, 20052, Italy
| | - G Seravalle
- Cardiology Department, Istituto Auxologico Italiano, IRCCS S. Luca Hpt, Milan, Italy
| | - N Koylan
- Anadolu Saglik Merkezi, Istanbul, Turkey
| | - I Nalbantgil
- Department of Cardiology, Ege University, Izmir, Turkey
| | - N Cagla
- Düzen Labaratuvarları, Ankara, Turkey
| | - Y Korkut
- Primary Care Department, Dumlupinar University, Kutahyta, Turkey
| | - F Quarti-Trevano
- Clinica Medica, Università Milano Bicocca, via Pergolesi 33, Monza-Milan, 20052, Italy
| | - W Makel
- Clinical Research Facilities International B.V., Schaijk, The Netherlands
| | - G Grassi
- Clinica Medica, Università Milano Bicocca, via Pergolesi 33, Monza-Milan, 20052, Italy.
- IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
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Celik T, Fici F. The association between inflammation and left ventricular diastolic dysfunction in patients with hypertension: another piece of the puzzle. Nutr Metab Cardiovasc Dis 2013; 23:e26-e27. [PMID: 23578829 DOI: 10.1016/j.numecd.2013.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 02/12/2013] [Indexed: 11/26/2022]
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Celik T, Yuksel UC, Bugan B, Celik M, Fici F, Iyisoy A, Kilic S, Sonmez A, Yaman H, Isik E. P-wave dispersion and its relationship to aortic elasticity in young prehypertensive patients. Am J Hypertens 2009; 22:1270-5. [PMID: 19779469 DOI: 10.1038/ajh.2009.157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Prolonged P-wave duration (P(dur)) and increased P-wave dispersion (PWD) are independent predictors of atrial fibrillation (AF) in patients with hypertension. This study was designed to evaluate the possible relationship between aortic elasticity and PWD in young prehypertensive patients. METHODS Twenty-five newly diagnosed prehypertensive patients (18 men, mean age = 34 +/- 6 years) and 25 healthy control subjects (16 men, mean age = 33 +/- 6 years) were enrolled in the study. The P(dur) measurements were calculated using a 12-lead surface electrocardiogram (ECG). Aortic elasticity parameters were derived from aortic diameters measured by echocardiography, and simultaneous blood pressure (BP) measurements by sphygmomanometry. RESULTS The baseline characteristics of patients with prehypertension were homogeneous with those of the controls. PWD and P(maximum) values were found to be higher in patients with prehypertension as compared to those of the controls (PWD; 65 ms vs. 35 ms, P < 0.001; P(maximum); 110 ms vs. 80 ms, P < 0.001). However, P(minimum) values were not significantly different between the two groups (40 ms vs. 45 ms, P = 0.358). Also, a moderate positive correlation was found between stiffness index (SI) and PWD (r = 0.500, P = 0.011), and a moderate negative correlation between aortic elasticity parameters (aortic distensibility and strain indexes) and PWD (for aortic distensibility, r = -0.498, P = 0.011; for strain index, r = -0.578, P = 0.002), in patients with prehypertension. CONCLUSIONS Young patients with prehypertension have increased PWD and arterial stiffness. These parameters are correlated and may pose additional risk factors for future cardiovascular events.
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Abstract
Nebivolol has been adequately tested in clinical efficacy trials of patients with mild hypertension. Clinical efficacy trials or their meta-analyses did not accurately predict the outcome of subsequent large studies. The primary objective was to assess the efficacy/safety of nebivolol 5-10 mg daily in a nationwide study of patients with mild hypertension. Secondary objectives were (1) to compare efficacy/safety as monotherapy versus add-on therapy and (2) to assess the effect of nebivolol on ISH. This was an open-label, 6-week follow-up study of 6,356 patients with mild hypertension or ISH, as defined by the 1999 World Health Organization guidelines, recruited from 2,700 facilities. Previous monotherapies were continued except for beta-blockers. Results are reported as means+/-SDs. Intention-to-treat analysis is given. A total of 5,740 patients completed the study; of the withdrawals, 90% were lost for follow-up or were noncompliant, 38% were untreated before, 23% had beta-blockers. In the accumulated data, mean systolic and diastolic blood pressures fell by 24+/-14 and 13+/-9 mm Hg (both P<0.001). The differences between the blood pressure-reducing effects of nebivolol monotherapy and add-on therapy were not statistically significant: 28+/-16 and 22+/-14 mm Hg for systolic and 15+/-11 and 11+/-8 mm Hg for diastolic blood pressures. Adverse events were limited to 0.5% of the patients, no serious adverse events were observed. In the ISH patients, diastolic blood pressure fell by 4+/-6 mm Hg compared with 15+/-10 mm Hg in the no-ISH patients (P<0.01). Efficacy-safety effects of nebivolol in patients with mild hypertension can be generalized in a nationwide assessment. The efficacy of nebivolol as monotherapy and as the efficacy as add-on therapy are very similar. Nebivolol is highly efficacious in patients with ISH.
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Affiliation(s)
- T J Cleophas
- Department Medicine, Albert Schweitzer Hospital, Dordrecht, Netherlands.
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Abaci A, Oguz A, Kozan O, Toprak N, Senocak H, Deger N, Sahin M, Sur H, Fici F, Erol C. Treatment and control of hypertension in Turkish population: a survey on high blood pressure in primary care (the TURKSAHA study). J Hum Hypertens 2006; 20:355-61. [PMID: 16511506 DOI: 10.1038/sj.jhh.1001995] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although the management and the control rates of hypertension are generally low throughout the world, there are substantial differences between the countries. The aim of this study was to determine the control rate of blood pressure and the characteristics of the patients who have been admitted to primary care units in Turkey. Our study included 16,270 patients aged above 18 years who were diagnosed as hypertensive in representative nationwide sample of 1,000 primary care units in Turkey. The mean age of the patients was 60+/-11 years (60.1% women). Of 16,270 patients, 15 187 (93.3%) were on an antihypertensive treatment, whereas 1,083 (6.7%) were receiving no treatment. The patients who were women, diabetic, smoker, obese, and those who had a concomitant cardiovascular disease (CVD) had a higher rate of antihypertensive treatment. Of 15,187 treated patients, 4,912 (30.2%) had a controlled systolic blood pressure, 7,063 (43.4%) a controlled diastolic blood pressure, and in 3,931 (24.2%), both were under control. A logistic regression analysis demonstrated that age (OR 1.33), diabetes (OR 4.96), body mass index (OR 1.41) and the presence of a CVD (OR 1.19) were predictors for blood pressure being under control. The blood pressure control rates ranged between 16.6 and 30.5% among seven geographical regions. In the primary care units in Turkey, the blood pressure control rate is consistently low in treated hypertensive patients. In addition, there are differences between the geographical regions in both the proportion of those receiving medications and the blood pressure control rates.
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Affiliation(s)
- A Abaci
- Department of Cardiology, School of Medicine, Gazi University, Ankara, Turkey.
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Demirel S, Akkaya V, Cine N, Oflaz H, Yekeler E, Ozturk S, Cleophas TJ, Fici F. Genetic polymorphisms and endothelial dysfunction in patients with essential hypertension: a cross-sectional case-control study. Neth Heart J 2005; 13:126-131. [PMID: 25696471 PMCID: PMC2497295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Both in animal models and humans an association between endothelial constitutive nitric oxide synthase (ecNOS) gene polymorphism and the development of hypertension has been found. However, the relation between ecNOS polymorphism and endothelial function in patients with hypertension has not been systematically studied. Genes of the renin-angiotensin system include the angiotensin-converting enzyme (ACE) gene, and the angiotensin II type 1 receptor (ATIR) gene, and have been associated with essential hypertension. However, no consistent data are available about the relation between polymorphisms of these genes and the presence of endothelial dysfunction in such patients. OBJECTIVES To assess the presence of genetic polymorphisms and of endothelial dysfunction in patients with essential hypertension. To determine the effects of gene polymorphisms on endothelial dysfunction in these subjects. METHODS In 129 patients with essential hypertension and the same number of age-matched controls polymorphisms of the ecNOS gene, ACE gene, and AT1R gene were analysed by polymerase chain reactions. Endothelial function was assessed by maximal endothelial dependent vasodilation in response to reactive hyperaemia using high resolution ultrasound examinations of the brachial arteries. To assess correlation between genetic markers, endothelial function, and the presence of hypertension both univariate and multivariate analyses were used including Pearson's and Spearman's correlation coefficients, and multiple logistic regressions. RESULTS The size of endothelium-dependent vasodilation between patients and controls differed by 16% (p<0.02). However, the presence of genetic polymorphisms of the ecNOS, ACE, and AT1R genes did not significantly differ between patients and controls. Neither were there any statistically significant differences in endothelial function between various genotypes of the three genes. This was so for both the patients and the controls, although in all of these comparisons the controls overall displayed a slightly better endothelial function than the patients did. Multiple regression analysis with endothelial dysfunction as dependent and the presence of gene polymorphisms as independent variables did not reveal any significant correlation either. CONCLUSION A significant relation between endothelial dysfunction and essential hypertension was demonstrated. However, no relations between genetic markers and the presence of essential hypertension or between endothelial dysfunction and genetic markers were established. The failure of our study to demonstrate the latter may be due to confounders. Also, other genes may be more important in the pathogenesis of endothelial dysfunction and essential hypertension. The current study underscores that endothelial dysfunction and hypertension are not simple genetic disorders, and that they are, essentially, multicausal.
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Cazzola M, Matera MG, Tufano MA, Catalanotti P, Polverino M, Cantoni V, Fici F, Sarlo F, Rossi F. Pulmonary disposition of lomefloxacin in patients with acute exacerbation of chronic obstructive pulmonary disease. A multiple-dose study. J Chemother 2001; 13:407-12. [PMID: 11589484 DOI: 10.1179/joc.2001.13.4.407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
In this study we have measured the concentrations of lomefloxacin at steady state in serum and in the intrapulmonary region at specified intervals for 24 h following administration of the last dose of drug in patients suffering from acute exacerbation of chronic obstructive pulmonary disease (COPD). Twenty subjects were enrolled. They received lomefloxacin 400 mg orally once-daily for 5 consecutive days. All patients were divided into five groups, with 4 subjects in each group, according to sampling times (2, 4, 8, 12, and 24 h after the last dose). At bronchoscopy, bronchial biopsies and bronchoalveolar lavage (BAL) were performed. At 12 h after the last dose, serum concentration of lomefloxacin was >1.0 microg/mL and at 24 h it was still detectable, but, at all times, the concentrations in bronchial secretion, bronchial mucosa, and epithelial lining fluid (ELF) were greater than the concentrations in serum [bronchial secretions (pg/mL) = 2.5+/-1.2; 2.2+/-1.0: 2.0+/-1.1; 1.8+/-1.1; 0.6+/-0.3. bronchial mucosa (microg/g) = 5.9+/-2.1; 6.2+/-1.8; 2.6+/-2.2; 1.9+/-1.5; 1.0+/-0.9. ELF (microg/mL) = 6.9+/-2.8; 5.9+/-2.6; 3.1+/-1.9; 2.2+/-1.0; 0.8+/-1.3. serum (microg/mL) = 3.2+/-1.4; 2.8+/-0.9: 2.1+/-1.5; 1.2+/-1.1; 0.4+/-0.81. We must stress that we observed a large inter-individual variability in concentrations. Our data show that lomefloxacin once-daily induces high and sustained concentrations in the various potential sites of pulmonary infection and clearly indicate that the pharmacokinetic behavior of this fluoroquinolone permits once-daily administration in patients with acute exacerbations of COPD.
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Affiliation(s)
- M Cazzola
- Divisione di Pneumologia ed Allergologia e Settore di Farmacologia Clinica Respiratoria, AORN A. Cardarelli, Napoli, Italy.
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Abstract
Beta-adrenergic receptor antagonists are currently used as first-line therapy in the treatment of hypertension and angina pectoris, but are contraindicated or used with caution in patients with bronchospastic syndromes. In this study we evaluated in vivo the effects of nebivolol on airway responsiveness compared to atenolol, pindolol, and propranolol. In New Zealand white rabbits total lung resistance (R(L)) and dynamic compliance (Cdyn) were calculated. In acute protocol, the animals were intravenously injected with the beta-blockers at different doses while in the chronic protocol, animals were daily injected for 30 days. Furthermore, the changes induced by beta-blockers (higher doses) in R(L) and Cdyn after a treatment with salbutamol were calculated. In acute treatment, airway responsiveness to histamine was not modified by nebivolol at any dosage, but increased significantly following the exposure to the higher doses of the other beta-blockers. In chronic treatment, the thirty-day exposure to nebivolol, did not modify the airway responsiveness to histamine, whereas the other beta-blockers significantly increased airway responsiveness. Moreover, nebivolol affected the salbutamol-induced relaxation less markedly than other beta-blockers do. These data demonstrate that nebivolol respect the other beta-blockers used in this study, does not significantly affect the airway responsiveness, therefore it could be used in patients with both cardiovascular and bronchial diseases more safely than other beta-blockers drugs.
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Affiliation(s)
- B D'Agostino
- Institute of Pharmacology and Toxicology, Faculty of Medicine and Surgery, 2nd University of Naples, Italy.
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Loffreda A, Matera MG, Vacca C, Motola G, De Santis D, Ruggiero A, Russo F, Fici F, Cantoni V, Lampa E, Rossi F. Bioequivalence assessment of two different tablet formulations of diltiazem after single and repeated doses in healthy subjects. Curr Med Res Opin 1999; 15:53-61. [PMID: 10216812 DOI: 10.1185/03007999909115174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The study was performed on 14 healthy volunteers in order to compare the pharmacokinetics and hence assess the bioequivalence of two different tablet formulations of diltiazem administered orally. The study was carried out after single doses (60 mg) and repeated doses (60 mg three times a day for six days and 60 mg on the seventh day) according to a randomised, cross-over, open design. The pharmacokinetic parameters AUC0-infinity (ng h/ml), Tmax(h) and Cmax (ng/ml) were calculated for the two formulations after a single dose, while AUCt1-t2 (= AUC for a repetitive dose interval or dosing cycle, ng h/ml) and PTF (peak trough fluctuation) were calculated after repeated doses. The bioequivalence assessment was the shortest 90% confidence interval for the ratio (difference) of expected medians in the respective bioequivalence range (0.80-1.20). The results of this study show that, after either a single dose or repeated doses of test or reference formulations of diltiazem, the pharmacokinetics of the two formulations are similar. The ratios of AUC on day 1 (for single-dose treatment) and on day 7 (for repeated-dose treatment), and the corresponding 90% confidence intervals demonstrate bioequivalence between the two formulations of diltiazem within the accepted range of 0.80-1.20 (80-120%).
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Affiliation(s)
- A Loffreda
- Pharmacology and Toxicology Institute, Medical School, Second University of Naples, Italy
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11
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Abstract
Nebivolol is a new selective beta 1-adrenergic blocking agent, that possesses a peculiar pharmacodynamic profile and an original chemical structure, by which it differs from traditional beta 1-blockers. Nebivolol is a racemic mixture of two enantiomers in equal ratios. It is endowed with a highly selective beta 1-blocking activity, and does not show an intrinsic sympathomimetic activity. Nebivolol is endowed with peripheral vasodilating properties mediated by the modulation of the endogenous production of nitric oxide. It does not significantly decrease airway conductance compared with atenolol and propranolol. Nebivolol does not compromise the left ventricular function, but it may increase stroke volume, and does not reduce heart inotropism during exertion. Nebivolol is quite safe and is well tolerated, also when compared to traditional beta-blockers. The most common adverse effects are dizziness, headache and fatigue. Owing to its combined dual mechanism of action, nebivolol leads to a unique haemodynamic and therapeutic profile by which it may be advantageous in essential hypertension, ischaemic heart disease and congestive heart failure.
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Affiliation(s)
- M Mangrella
- Institute of Pharmacology and Toxicology, Faculty of Medicine and Surgery, 2nd University of Naples, Italy
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Stella L, de Novellis V, Vacca C, Guarino A, Cantoni V, Fici F, Rossi F. Antiarrhythmic effects of LR-A/113 a new calcium antagonistic drug. Res Commun Mol Pathol Pharmacol 1996; 93:235-48. [PMID: 8884994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LR-A/113 is a benzothiazepine drug similar to diltiazem with Ca(2+)-antagonist properties. Our previous studies showed that LR-A/113 determines anthypertensive effects comparable to diltiazem in normotensive and hypertensive rats. The aim of this study is to determine LR-A/113 effects respect to verapamil and diltiazem on CaCl2, aconitine and ouabain arrhythmias. Experiments were carried out on normotensive anesthetized rats and guinea pigs treated with CaCl2, aconitine and ouabaine and pretreated or not with verapamil, diltiazem or LR-A/113. Verapamil, diltiazem and LR-A/113, significantly delayed onset of arrhythmias and cardiac standstill induced by CaCl2 and aconitine. Moreover, pretreatments with verapamil, diltiazem or LR-A/113 reduced occurrence of arrhythmias in animals. In our models of arrhythmias LR-A/113 showed a significant antiarrhythmic effect of a magnitude almost similar to diltiazem but lower than for verapamil.
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Affiliation(s)
- L Stella
- Institute of Pharmacology and Toxicology Faculty of Medicine, University of Naples, Italy
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Salimbeni A, Canevotti R, Paleari F, Poma D, Caliari S, Fici F, Cirillo R, Renzetti AR, Subissi A, Belvisi L. N-3-substituted pyrimidinones as potent, orally active, AT1 selective angiotensin II receptor antagonists. J Med Chem 1995; 38:4806-20. [PMID: 7490730 DOI: 10.1021/jm00024a008] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A novel series of nonpeptide angiotensin II (A II) antagonists containing a pyrimidinone ring which carries a C-linked biphenyltetrazole moiety and a carboxyheteroaryl group on the 3-position have been prepared. Their affinity for the AT1 receptor was determined in a binding assay on rat adrenal cortical membranes. The in vivo antihypertensive properties were tested by evaluating the inhibition of the pressor response to A II followed by iv and id administration. Extensive molecular modeling studies, including comparison of molecular electrostatic potential distributions, conformational analysis, and overlays on a computational pharmacophore model of A II, were used to evaluate structural parameters of the new compounds, in comparison to other known A II antagonists (e.g., DUP-753 and SK&F 108566). According to the modeling studies, the introduction of a (carboxyheteroaryl)methyl moiety at the 3-position of the pyrimidinone ring led to derivatives with increased potency. Methyl 2-[[4-butyl-2-methyl-6-oxo-5-[[2'-(1H-tetrazol-5-yl)[1,1'-biphenyl ]- 4-yl]methyl]-1-(6H)-pyrimidinyl]methyl]-3-thiophenecarboxylate (3k, LR-B/081), one of the most potent compounds in the series (Ki = 1.4 nM), exhibited a marked antihypertensive activity on oral administration to conscious renal hypertensive rats, with long duration of action. It was selected for clinical evaluation in the treatment of hypertension in man.
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Affiliation(s)
- A Salimbeni
- Medicinal Chemistry Department, Istituto Lusofarmaco, Milano, Italy
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Rossi F, Matera MG, Filippelli A, Giasi M, Fici F. [The therapeutic prospects of ischemic cardiopathy]. Clin Ter 1994; 144:333-53. [PMID: 8205757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Having thoroughly reviewed the risk factors and pathophysiologic features of ischemic heart disease, the authors describe therapeutic protocols at present in use and take stock of the perspectives opened by new drugs with different kinetic and dynamic and more advanced properties compared to those at present in use.
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Affiliation(s)
- F Rossi
- Facoltà di Medicina e Chirurgia, II Università degli Studi di Napoli
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15
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Rossi F, Marrazzo R, Berrino L, De Santis D, Lisa M, Susanna V, Montanaro C, Fici F, Marmo E. Prenatal and postnatal thallium exposure in rats: effect on development of vasomotor reactivity in pups. Teratog Carcinog Mutagen 1988; 8:13-23. [PMID: 2897721 DOI: 10.1002/tcm.1770080103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Vasomotor reactivity has been evaluated in rats exposed perinatally and postnatally to thallium sulphate (1 mg/dl in their drinking water ad libitum). Prenatal and postnatal exposure to thallium did not modify the values of the systolic arterial blood pressure on the 30th and 60th day in pups of normotensive and DOCA-hypertensive rats. The hypertensive responses induced by endosinusal carotid hypotension and by 1-noradrenaline in pups of normotensive and DOCA-hypertensive rats, exposed or not exposed to thallium sulphate, were more intensive on the 60th than on the 30th day. Similar effects were observed for the hypotensive responses induced by 1-isoprenaline and acetylcholine. Prenatal exposure to thallium did not modify hypertensive responses induced by endosinusal carotid hypotension on the 30th and 60th days, but it caused a decrease of hypertensive responses induced by 1-noradrenaline on the 30th and 60th days and hypotensive responses induced by 1-isoprenaline and acetylcholine exclusively on the 60th day. Postnatal exposure to thallium did not modify hypertensive responses induced by endosinusal carotid hypotension and hypotensive responses induced by acetylcholine, but it caused a decrease of hypertensive responses induced by 1-noradrenaline on the 30th and 60th days in pups of normotensive rats and exclusively on the 60th day in pups of DOCA-hypertensive rats. Moreover, postnatal exposure to thallium caused a decrease of the hypotensive response induced by 1-isoprenaline exclusively on the 60th day. Our findings show that prenatal and postnatal exposure to thallium sulphate modifies the rat's developing vascular autonomic nervous system with a reduction of the alpha, beta-adrenergic and muscarinic vasomotor reactivity.
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Affiliation(s)
- F Rossi
- Department of Pharmacology and Toxicology, First Faculty of Medicine and Surgery, University of Naples, Italy
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16
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Zito M, Corneli C, Cervone C, D'Aviero M, Santicchia S, Amatetti M, Guarino F, Fici F, Abate G. Hypertension in the elderly. A retrospective study in institutionalized subjects. Riv Eur Sci Med Farmacol 1987; 9:185-92. [PMID: 3508594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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17
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Rosatti F, Fici F, Chieppa S, Giasi M, Preti R, Rossi F, Marmo E. [Diltiazem in the therapy of arterial hypertension: polygraphic evaluation of left ventricular performance]. Cardiologia 1985; 30:309-12. [PMID: 3833344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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18
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Passariello N, Fici F, Giugliano D, Ceriello A, Dello Russo P, Sgambato S. Effects of pyridoxine alpha-ketoglutarate on blood glucose and lactate in type I and II diabetics. Int J Clin Pharmacol Ther Toxicol 1983; 21:252-6. [PMID: 6862730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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19
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Belvisi A, Matergi M, Fici F. Treatment of hyperlactacidemia in cirrhotic patients with pyridoxine-alpha-ketoglutarate (PAK). Int J Clin Pharmacol Ther Toxicol 1982; 20:142-6. [PMID: 7068288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
After pyridoxine-alpha-ketoglutarate (PAK) was administered to patients with hepatic cirrhosis, the blood level values for lactic acid and ammonia showed a statistically significant reduction. These results suggest that PAK can be used for treatment adn prevention of hyperlactacidemia secondary to chronic hepatopathy.
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20
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Salerno F, Lorenzini MC, Conti M, Abbiati R, Fici F. Effect of pyridoxine-2-oxoglutarate administration in patients with advanced cirrhosis: control of ammonia pyruvate and lactate high plasma concentrations. Adv Exp Med Biol 1982; 153:479-85. [PMID: 6762055 DOI: 10.1007/978-1-4757-6903-6_59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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21
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22
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23
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Capretti L, Fici F, Coscelli C, Butturini U. Pyridoxine-alpha-ketoglutarate in the treatment of experimental lactic acidosis in the rat. Horm Metab Res 1981; 13:472-3. [PMID: 7327528 DOI: 10.1055/s-2007-1019307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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24
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Missale G, Camarri E, Fici F, Agosti A, Di Murro R. Effect of dihydroxydibutylether on the lithogenic index of patients with cholesterol gallstones. Int J Clin Pharmacol Ther Toxicol 1981; 19:273-4. [PMID: 7309300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Daily administration of 900 mg dihydroxydibutylether (DHBE) produced a significant reduction of lithogenic index in patients with cholesterol gallstones. After treatment with placebo, in the same subjects the lithogenic index rises significantly. The activity of DHBE is not casual.
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25
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Missale G, Camarri E, Fici F, Agosti A, Mordini M. Preliminary results on the action of dihydroxydibutylether on the lithogenic index of patients with calculosis of the gall-bladder. Int J Clin Pharmacol Ther Toxicol 1980; 18:42-3. [PMID: 7364531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Oral administration of 900 mg daily of dihydroxydibutylether to patients with cholesterol stones in the gall-bladder, reduced the lithogenic index of the bile, whose mean value shifted from 1.64 to 1.03 (p less than 0.01) after 20 days of treatment. Reduction of lithogenic index must be ascribed exclusively to the reduced biliary concentration of cholesterol.
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26
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Camarri E, Fici F, Marcolongo R. Influence of chenodeoxycholic acid on serum triglycerides in patients with primary hypertriglyceridemia. Int J Clin Pharmacol Biopharm 1978; 16:523-6. [PMID: 365796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Administration of chenodeoxycholic acid (CDCA) to patients with primary hypertriglyceridemia caused the diminution of serum triglyceride concentrations of 54.31% and 46.04% at dosages of 500 mg/day and of 250 mg/day, respectively. Results after 1 month of treatment with 250 mg/day are not statistically different from those obtained with 500 mg/day. Administration of CDCA did not change the serum cholesterol, SGOT, SGPT, total bilirubin, gammaGT or alkaline phosphatase levels.
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27
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Dotti M, Lepore R, Franchi A, Fici F. Clinical evaluation of dexamethasone 17-valerate in the topical therapy of eczema. Panminerva Med 1978; 20:191-66. [PMID: 757286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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28
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Martini C, Fici F. Acute poisoning with melitracen--absence of ECG changes. Int J Clin Pharmacol Biopharm 1978; 16:129-31. [PMID: 649231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The clinical course of the first case of acute poisoning from melitracen, a tricyclic antidepressant, is described, whose symptomatology was characterized by the absence of cardiovascular changes (ECG, arterial pressure, cardiac frequency). Central anticholinergic effects of the drug, as excitement, hallucinations, space and time disorientation, regressed with the administration of diazepam.
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29
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Fici F, Del Vecchio F, Apolito A. Comparative antibiotic efficacy studied by probit analysis of clinical data. Chemotherapy 1978; 24:112-7. [PMID: 620610 DOI: 10.1159/000237769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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30
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Ray M, Salerno JA, Chimienti M, Storti D, Fici F, Tavazzi L, Bobba P. [Evaluation by means of atrial pacing of the hemodynamic and clinical effects of a delayed-action isosorbide dinitrate preparation in patients with angina pectoris]. Minerva Cardioangiol 1977; 23:53-62. [PMID: 840399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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31
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Fici F, Camarri E, Galluzzi F, Bagnoli M. Evaluation of choleretic activity of dihydroxydibutyl ether. Curr Ther Res Clin Exp 1976; 20:772-93. [PMID: 827424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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32
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Fici F, Abbate G, Leonessa V, Alagia I. [Therapeutic activity of a neomycin-bacitracin combination in primary bacterial enteritis]. Clin Ter 1976; 77:329-45. [PMID: 795589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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33
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Marmo E, Vacca C, Saini RK, Fici F. Absorption studies with ritodrine an adrenergic beta stimulant drug. Boll Chim Farm 1974; 113:559-61. [PMID: 4447682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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34
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Fici F, Abbate GF, Astarita C, Gattoni A. [Clinical trial of an association of 2 semisynthetic penicillins: dicloxacillin and hetacillin]. Minerva Med 1973; 64:4325-31. [PMID: 4587771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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35
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Fici F, Abbate GF, Astarita C, Gattoni A. [Hematic concentration and urinary excretion of Dicloeta]. Minerva Med 1973; 64:4319-24. [PMID: 4795222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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36
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Varone GL, Catalano G, Abbate GF, Fici F. [Antibacterial activity in vitro and in vivo in animals of a combination of 2 semisynthetic penicillins: dicloxacillin and ethacillin]. G Mal Infett Parassit 1972; 24:231-42. [PMID: 5050303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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37
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Ambrosioni E, Perri G, Pascucci E, Fici F. [Clinical evaluation of the delayed-action isoxsuprin on peripheral circulation]. G Clin Med 1971; 52:552-63. [PMID: 5152348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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